摘要
目的:对行机械通气的危重患者预防性实施综合肠道刺激,观察其对患者胃肠功能的影响.方法:将100例行机械通气的危重患者按随机数字表法分为干预组和对照组,每组各50例,对照组患者采用常规的治疗方案,干预组在对照的基础上给予综合肠道刺激.比较两组患者胃肠功能障碍的发生率、胃泌素水平及腹腔内压力,对两组发生胃肠功能障碍的患者进行急性胃损伤分级.结果:干预组胃肠功能障碍发生率为32.0%(16/50),显著低于对照组54.0%(27/50),差异有统计学意义(?2=4.937,P=0.026).干预组腹泻、腹胀、中毒性肠麻痹及应激性溃疡出血的发生率均显著低于对照组(P<0.05).干预组发生胃肠功能障碍的患者胃泌素水平及腹腔内压力均显著低于对照组(P<0.05).干预组Ⅲ级急性胃损伤的比例为6.25%(1/16),显著低于对照组33.33%(9/27)(P<0.05).结论:对于机械通气的危重患者预防性的实施综合肠道刺激,可有效降低胃肠功能障碍的发生率,减轻胃肠功能损伤的程度.
AIM：To apply preventive comprehensive intestinal irritation in mechanically ventilated critically ill patients,and observe its impact on patients＇ gastrointestinal function.METHODS：One hundred mechanically ventilated critical patients were randomly divided into an intervention group and a control group,with 50 patients in each group.The control group underwent conventional treatment,and the intervention group was additionally given comprehensive intestinal irritation on the basis of conventional treatment.The incidence of gastrointestinal dysfunction,gastrin levels and intra-abdominal pressure were compared between the two groups.Gastrointestinal dysfunction was classified using the acute gastric injury classification system.RESULTS：The incidence of gastrointestinal dysfunction in the intervention group was32.0%（16/50）,significantly lower than that in the control group[54.0%（27/50）;x2 = 4.937,P= 0.026].The rates of diarrhea,bloating,toxic intestinal paralysis and stress ulcer bleeding in the intervention group were significantly lower than those in the control group（P〈0.05）.Gastrin levels and intra-abdominal pressure in gastrointestinal dysfunction patients of the intervention group were significantly lower than those of the control group（P〈0.05）.The rate of grade Ⅲ acute gastric injury in the intervention group was 6.25%（1/16）,significantly lower than that in the control group[33.33%（9/27）;P〈0.05].CONCLUSION：Comprehensive preventive intestinal irritation applied in mechanically ventilated critically ill patients can effectively reduce the incidence of gastrointestinal dysfunction and the extent of gastrointestinal injury.
出处
《世界华人消化杂志》
CAS
2015年第34期5544-5548,共5页
World Chinese Journal of Digestology
关键词
胃肠功能障碍
肠道刺激
机械通气
危重症
Gastrointestinal dysfunction
Intestinal irritation
Mechanical ventilation
Critically ill
