摘要
目的探讨床旁超声监测胃残余量(GRV)指导重症烧伤患者早期肠内营养(EN)的应用效果。方法选取2022年1月至2023年6月徐州医科大学附属淮海医院烧伤整形科诊治的66例重症烧伤患者进行前瞻性随机对照研究。按烧伤严重程度分为重度烧伤患者(36例)与特重度烧伤患者(30例)。按照随机数字表法将重度烧伤患者分为观察组(予床旁超声监测GRV)与对照组(予注射器抽取胃内容物估测GRV),每组18例;将特重度烧伤患者分为观察组(予床旁超声监测GRV)与对照组(予注射器抽取胃内容物估测GRV),每组15例。分别于治疗1、3、5、7、14、21、28 d,对比4组患者治疗期间肠内营养摄入总能量、喂养不耐受发生率、血红蛋白(Hb)、总蛋白(TP)、白蛋白(ALB)、球蛋白(GLB)、前白蛋白(PA)、降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、尿素氮(BUN)、机械通气时间、喂养达标时间、BICU住院时间、脓毒症发生率。对数据行Fisher确切概率法、Mann-Whitmey U检验、独立样本t检验、重复测量方差分析。结果重度烧伤和特重度烧伤患者观察组的喂养不耐受发生率均低于对照组(P<0.05)。特重度烧伤患者在治疗7、28 d,观察组Hb高于对照组(P<0.05)。重度烧伤患者在治疗1~7 d,观察组TP高于对照组(P<0.05)。重度烧伤及特重度烧伤患者在治疗3~14 d,观察组ALB高于对照组(P<0.05)。重度烧伤患者在治疗5~21 d,观察组PA高于对照组(P<0.05);特重度烧伤患者在治疗5~28 d,观察组PA高于对照组(P<0.05)。重度烧伤患者在治疗1~5 d、14 d,观察组PCT低于对照组(P<0.05);特重度烧伤患者在治疗3~14 d,观察组PCT低于对照组(P<0.05)。特重度烧伤患者在治疗3、5 d,观察组IL-6低于对照组(P<0.05)。特重度烧伤患者观察组喂养达标时间短于对照组(P<0.05)。结论床旁超声监测重症烧伤患者GRV可以指导早期肠内营养治疗,有利于提高肠内营养总能量,降低喂�
Objective To investigate the effect of bedside ultrasound monitoring gastric residual volume(GRV)on guiding early enteral nutrition(EN)in BICU patients.Methods Totally 66 BICU patients diagnosed and treated at Department of Burns and Plastic Surgery,Affiliated Huaihai Hospital of Xuzhou Medical University from January 2022 to June 2023 were enrolled into the prospective randomized contolled trial,including 36 severe burn patients and 30 extremely severe burn patients according to the severity of burn.According to the random number table method,the patients with severe burn were divided into observation group(with bedside ultrasound monitoring of GRV)and control group(with syringe extraction of gastric contents to estimate GRV),with 18 cases in each group.The patients with extremely severe burn were divided into observation group(with bedside ultrasound monitoring of GRV)and control group(with syringe extraction of gastric contents to estimate GRV),with 15 cases in each group.After 1,3,5,7,14,21 and 28 days of treatment,total energy intake of enteral nutrition,incidence of feeding intolerance,hemoglobin(Hb),total protein(TP),albumin(ALB),globulin(GLB),prealbumin(PA),procalcitonin(PCT),C-reactive protein(CRP),interleukin-6(IL-6),blood urea nitrogen(BUN),mechanical ventilation time,feeding compliance time,BICU hospitalization time and sepsis incidence were compared among 4 groups during treatment.Fisher exact probability test,Mann-Whitmey U test,independent sample t test and repeated analysis of measurement variance were used for data analysis.Results The incidence of feeding intolerance in the observation group was lower than that in the control group for both severe burn patients and extremely severe burn patients(P<0.05).In the treatment of 7 and 28 d,the Hb level of the observation group was higher than that of the control group in extemely severe burn patients(P<0.05).In the treatment of 1-7 days,the TP level of the observation group was higher than that of the control group in severe burn patients(P<0.05).In t
作者
李鹏
崔庆伟
张盼
唐浩
庄梦梦
孙晗
孙媛
李丹
陈文娣
毛学飞
孙勇
Li Peng;Cui Qingwei;Zhang Pan;Tang Hao;Zhuang Mengmeng;Sun Han;Sun Yuan;Li Dan;Chen Wendi;Mao Xuefei;Sun Yong(Department of Burns and Plastic Surgery,the 71st Group Army Hospital of Army,Affiliated Huaihai Hospital of Xuzhou Medical University,Xuzhou 221004,China)
出处
《中华损伤与修复杂志（电子版）》
CAS
2024年第1期24-33,共10页
Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)
基金
国家自然科学基金面上项目(81772082)
陆军第七十一集团军医院院内重点课题(YNZD-202202)。
关键词
床旁超声监测
胃残余量
重症烧伤
早期肠内营养
Bedside ultrasonic monitoring
Gastric residual volume
BICU patients
Early enteral nutrition
