目的使用改良B超胃窦单切面法检测胃窦运动指数(motility index,MI)来指导神经重症患者的经胃营养,避免空肠营养的副作用,同时最大限度减少反流误吸的不良后果。方法选取格拉斯哥昏迷评分(Glasgow coma scale,GCS)<8分的神经重症患...目的使用改良B超胃窦单切面法检测胃窦运动指数(motility index,MI)来指导神经重症患者的经胃营养,避免空肠营养的副作用,同时最大限度减少反流误吸的不良后果。方法选取格拉斯哥昏迷评分(Glasgow coma scale,GCS)<8分的神经重症患者18例作为研究组实施经胃营养,使用B超每日行胃窦单切面法测定空腹MI,确定当天的营养计划。同期选取19例GCS评分<8分的神经重症患者实施经空肠营养作为对照组,营养计划由主管医师根据经验制定,肠内营养实施期间,根据患者的胃残余量与胃肠道耐受性调整肠内营养(enteral nutrition,EN)速度与量。比较两组患者的一般情况、EN实施情况及并发症、预后相关指标等。结果研究组患者EN起始速度[(52.0±14.5)ml/h]高于对照组[(35.0±12.5)ml/h,P=0.045)];达全量营养(total enteral nutrition,TEN)的时间[(3.2±0.8)天)短于对照组[(5.2±0.9)天,P=0.048)];研究组的反流、新发肺炎、呕吐、腹泻及腹胀等并发症的发生率以及感染发生率、呼吸机使用时间及住ICU时间与对照组相比差异无统计学意义。结论使用超声导向的肠内营养方案指导经胃营养在神经重症患者中实施效果良好,不会增加感染及胃肠道不耐受等的发生率,是维护胃肠道结构功能完整性、最符合生理的肠内营养支持方式,可避免长期空肠喂养的副作用。展开更多
Steller chamaejasme L.(S. chamaejasme for short) is one of the most noxious unpalatable weeds in China, which has been frequently reported its negative interaction(i.e. competition and allelopathy) with other herbaceo...Steller chamaejasme L.(S. chamaejasme for short) is one of the most noxious unpalatable weeds in China, which has been frequently reported its negative interaction(i.e. competition and allelopathy) with other herbaceous species in grasslands. This study compared species diversity, biomass and sexual reproduction of herbaceous plants in meadows with S. chamaejasme and in open meadows without S. chamaejasme in overgrazing meadows on the Tibetan Plateau in China to determine whether positive facilitation exist between S. chamaejasme and other herbaceous species under livestock's overgrazing. The results showed that there are more herbaceous species in meadows with S. chamaejasme than those in open meadows(35s and30s, respectively). Diversity index and above-ground biomass were also significantly higher in meadows with S. chamaejasme. There were 39%(11/28) of all species with sexual reproduction found in meadows with S. chamaejasme, which was 7 times more than those in open meadows. Our study showed that S. chamaejasme could provide biotic refuge for neighboring plants and preserve plant diversity from livestock's overgrazing in alpine meadows on the Tibetan Plateau. It also suggested that inter-specific facilitation between S. chamaejasme and other herbaceous species may play a key role in overgrazing alpine meadows.展开更多
基金funded by the National Natural Science Foundation of China (Grant Nos. 31100360, 31200378, 31000233)
文摘Steller chamaejasme L.(S. chamaejasme for short) is one of the most noxious unpalatable weeds in China, which has been frequently reported its negative interaction(i.e. competition and allelopathy) with other herbaceous species in grasslands. This study compared species diversity, biomass and sexual reproduction of herbaceous plants in meadows with S. chamaejasme and in open meadows without S. chamaejasme in overgrazing meadows on the Tibetan Plateau in China to determine whether positive facilitation exist between S. chamaejasme and other herbaceous species under livestock's overgrazing. The results showed that there are more herbaceous species in meadows with S. chamaejasme than those in open meadows(35s and30s, respectively). Diversity index and above-ground biomass were also significantly higher in meadows with S. chamaejasme. There were 39%(11/28) of all species with sexual reproduction found in meadows with S. chamaejasme, which was 7 times more than those in open meadows. Our study showed that S. chamaejasme could provide biotic refuge for neighboring plants and preserve plant diversity from livestock's overgrazing in alpine meadows on the Tibetan Plateau. It also suggested that inter-specific facilitation between S. chamaejasme and other herbaceous species may play a key role in overgrazing alpine meadows.
