蚌埠医学院学报2024,Vol.49Issue(7) :953-956.DOI:10.13898/j.cnki.issn.1000-2200.2024.07.025

胃窦运动指数对ICU肠内营养病人喂养不耐受的预测价值

Predictive value of antral motility index for feeding intolerance in patients with enteral nutrition in ICU

付红 倪秀梅 宋云凤 周月琴
蚌埠医学院学报2024,Vol.49Issue(7) :953-956.DOI:10.13898/j.cnki.issn.1000-2200.2024.07.025

胃窦运动指数对ICU肠内营养病人喂养不耐受的预测价值

Predictive value of antral motility index for feeding intolerance in patients with enteral nutrition in ICU

付红 1倪秀梅 1宋云凤 1周月琴1
扫码查看

作者信息

  • 1. 安徽医科大学第一附属医院 重症医学科,安徽 合肥 230022
  • 折叠

摘要

目的:探讨床旁超声监测胃窦运动指数(MI)在预测ICU肠内营养(EN)病人喂养不耐受中的应用价值.方法:选取ICU经鼻胃管实施EN病人82 例,采用床旁超声于EN喂养第 1、2、3 天分别测量病人MI,并评估病人喂养不耐受发生情况.通过logistics多因素回归分析EN病人喂养不耐受发生的危险因素,绘制ROC曲线分析MI对喂养不耐受的预测价值.结果:ICU病人在EN实施第1、2、3 天喂养不耐受发生率分别为20.73%(17/82)、24.39%(20/82)、31.71%(26/82).单因素分析显示,机械通气、EN启动时间、镇静镇痛药物、MI、急性生理与慢性健康评分Ⅱ是喂养不耐受发生的影响因素(P<0.05~P<0.01);多因素分析显示,机械通气、EN启动时间和MI均为喂养不耐受发生的独立影响因素(P<0.05~P<0.01).MI预测喂养不耐受AUC为0.856,最佳截断值为0.556,敏感度为0.765,特异度为0.782.结论:ICU病人喂养不耐受发生率较高,机械通气、EN启动时间延迟及低MI是喂养不耐受发生的高危因素,监测MI值有助于预测喂养不耐受发生.

Abstract

Objective:To investigate the application value of antral motility index(MI)monitored by bedside ultrasound in predicting feeding intolerance of enteral nutrition(EN)patients in ICU.Methods:A total of 82 EN patients through nasogastric tube were selected from ICU.The MI was measured by bedside ultrasound at 1 d,2 d and 3 d of EN feeding,and the incidence of feeding intolerance was evaluated.The risk factors of FI occurrence were analyzed by logistics multiple-regression analysis,and the predictive value of MI to FI was analyzed by drawing ROC curve.Results:The incidence rates of FI in ICU patients at1 d,2 d and3 d of EN were20.7%(17/82),24.4%(20/82)and 31.7%(26/82),respectively.The results of univariate analysis showed that the mechanical ventilation,enteral nutrition initiation time,sedative and analgesic drugs,MI and APACHEⅡ score were the influencing factors of FI(P<0.05 to P<0.01).The results of multivariate analysis showed that the mechanical ventilation,start time of enteral nutrition and MI were the independent influencing factors of FI(P<0.05 to P<0.01).The area under ROC curve,optimal cut-off value,sensitivity and specificity of MI for predicting FI were 0.856,0.556,0.765 and 0.782,respectively.Conclusions:The incidence of feeding intolerance is high in ICU patients.The mechanical ventilation,start time of enteral nutrition delaying and low MI are the high risk factors of feeding intolerance,and monitoring MI value can help to predict the occurrence of feeding intolerance.

关键词

肠内营养/胃窦运动指数/床旁超声/喂养不耐受

Key words

enteral nutrition/antral motility index/bedside ultrasound/feeding intolerance

引用本文复制引用

基金项目

安徽省急危重症护理临床重点专科建设项目(皖卫传[2019]91号)

出版年

2024
蚌埠医学院学报
蚌埠医学院

蚌埠医学院学报

CSTPCD
影响因子:0.917
ISSN:1000-2200
参考文献量11
段落导航相关论文