重症超声联合肠内营养耐受性评分在脓毒症患者早期肠内营养中的应用

Application of severe ultrasound combined with enteral nutrition tolerance score in early enteral nutrition in patients with sepsis

目的探讨脓毒症患者中重症超声检查和肠内营养耐受性评估及其在早期肠内营养(EEN)中的应用价值。方法将2022年7月至2023年7月我科收治的86例脓毒症行早期肠内营养患者作为研究对象,采用随机数字表法分为对照组和研究组,每组43例。对照组给予常规注射器回抽检测胃残留结合肠内营养耐受性评估的方式进行肠内营养支持,研究组给予重症胃肠超声检查胃窦动力和胃残留结合肠内营养耐受性评估肠内营养支持方式,比较两组患者的急性生理与慢性健康评分(APACHEⅡ)、营养指标、免疫功能指标、临床指标、住院时间、病死率、不良反应发生率。结果治疗后,研究组的APACHEⅡ得分低于对照组,免疫功能指标和营养指标均优于对照组,差异均有统计学意义(均P<0.05)。两组患者的住院时间、机械通气时间和目标营养量达标时间均短于对照组,差异均有统计学意义(均P<0.05)。两组患者的病死率和不良反应发生率均低于对照组,差异均有统计学意义(均P<0.05)。结论对脓毒症患者采用重症超声检查和肠内营养耐受性评估管理方案可以更有效的提高患者抵抗力,提高营养状况,有利降低死亡率,减少不良反应发生率,值得临床应用。

Objective To investigate the application value of severe ultrasonography and enteral nutrition tolerance assessment in early enteral nutrition(EEN)in patients with sepsis.Methods A total of 86 patients with sepsis undergoing early enteral nutrition admitted to our department from July 2022 to July 2023 were divided into control group and study group by random number table method,with 43 cases in each group.The control group was given enteral nutrition support by routine syringe withdrawal detection of gastric residue combined with enteral nutrition tolerance evaluation,while the study group was given enteral nutrition support by severe gastrointestinal ultrasound examination of gastric antrum power and gastric residue combined with enteral nutrition tolerance evaluation.The acute physiological and chronic health scores(APACHEⅡ),nutritional indexes,immune function indexes,clinical indexes,length of hospital stay,mortality,and incidence of adverse reactions were compared between the two groups.Results After treatment,the APACHEⅡscore of study group was lower than that of control group,and the immune function indexes and nutritional indexes were better than those of control group,with statistical significance(all P<0.05).The length of hospital stays,mechanical ventilation time and time to reach target nutrition in 2 groups were shorter than those in control group,with statistical significance(all P<0.05).The mortality rate and incidence of adverse reactions in 2 groups were lower than those in control group,with statistical significance(all P<0.05).Conclusion Severe ultrasound examination and enteral nutrition tolerance assessment for sepsis patients can effectively improve patients'resistance,improve nutritional status,and reduce mortality and incidence of adverse reactions,which is worthy of clinical application.