临床误诊误治2025，Vol.38Issue(18)：40-44,5.DOI:10.3969/j.issn.1002-3429.2025.18.009
床旁胃超声在危重症患者胃残余量监测和预测肠内营养不耐受中的应用
Application of bedside gastric ultrasound in monitoring gastric residual volume and predicting enteral nutrition intolerance in critically ill patients
摘要
Abstract
Objective To analyze the value of bedside gastric ultrasound in monitoring gastric residual volume and predicting enteral nutrition intolerance in critically ill patients.Methods A total of 120 critically ill patients who received enteral nutrition after admission from January 2023 to May 2024 were selected as the research subjects.They were divided into the control group and the observation group,with 60 patients in each group according to random number table method.In the control group,gastric residual volume was monitored by syringe aspiration,while in the observation group,gastric residual volume was monitored by bedside gastric ultrasound.According to the tolerance of enteral nutrition,the patients in the observation group were divided into the tolerance subgroup and the non-tolerance subgroup.The time to achieve the feeding target,the duration of operation,the length of ICU stay,and the gastric residual volume at different time were compared between the observation group and the control group.The occurrence of complications such as reflux,aspiration,interruption of enteral nutrition and diarrhea was also statistically analyzed.Multivariate Logistic regression analyses were used to analyze the influencing factors of enteral nutrition intolerance,and the receiver operating characteristic(ROC)curve was used to analyze the predictive value of monitoring of gastric residual volume by bedside gastric ultrasound for enteral nutrition intolerance in critically ill patients.Results The time to achieve the feeding target and the duration of operation in the observation group were both shorter than those in the control group(P<0.05),while there was no significant difference in the length of ICU stay between the two groups(P>0.05).There was no significant difference in gastric residual volume between the two groups at different time points after enteral nutrition(P>0.05).There was no significant difference in the incidence of reflux,aspiration,interruption of enteral nutrition and diarrhea between the two groups(P>0.05).The gastric residual volume at 24 h after enteral nutrition in the tolerance subgroup as well as the proportions of patients using multiple antibiotics and receiving mechanical ventilation,was lower than that in the non-tolerance subgroup(P<0.05,P<0.01).The results of multivariate Logistic regression analysis showed that gastric residual volume at 24 h after enteral nutrition was an independent influencing factor of enteral nutrition intolerance(P<0.05).The results of ROC curve analysis showed that the area under the curve,specificity and sensitivity of bedside gastric ultrasound monitoring of gastric residual volume for predicting enteral nutrition intolerance were 0.711,71.40%and 64.10%,respectively.Conclusion Bedside gastric ultrasound for monitoring gastric residual volume in critically ill patients can shorten the time to reach the feeding target and the duration of operation,and has a good predictive value for enteral nutrition intolerance.关键词
危重症/肠内营养/耐受/床旁胃超声/胃残余量/预测/并发症Key words
critical illness/enteral nutrition/tolerance/bedside gastric ultrasound/gastric residual volume/prediction/complication引用本文复制引用
毛羡仪,陆培明,蒋殿虎,戴兆俊,陈清标,袁满涓..床旁胃超声在危重症患者胃残余量监测和预测肠内营养不耐受中的应用[J].临床误诊误治,2025,38(18):40-44,5.基金项目
2022年度广东省医学科研基金立项项目(B2022332) （B2022332）
2023年佛山市自筹经费类科技创新项目(2320001006493) （2320001006493）
