首页|肠道血氧饱和度监测对高位肠闭锁患儿术后肠内营养的影响

肠道血氧饱和度监测对高位肠闭锁患儿术后肠内营养的影响

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目的 评价肠道血氧饱和度监测在高位肠闭锁患儿术后肠内营养中的应用效果.方法 采用便利抽样法,选取入住新生儿外科的96例高位肠闭锁患儿为研究对象,根据入住时间将患儿分为两组,2018年7月至2020年12月入住的48例患儿分为对照组,2021年1月至2023年6月入住的48例分为观察组.两组术后给予全肠外营养支持,对照组术后48 h后遵医嘱开始实施肠内营养,喂养期间根据喂养耐受情况调整喂养方式.观察组术后即进行肠道血氧饱和度监测,24 h后若肠道血氧饱和度≥0.77时开始进行肠内营养,喂养期间持续监测肠道血氧饱和度,根据监测结果调整肠内营养.观察两组术后首次肠内营养时间、全量经口喂养时间、体质量、坏死性小肠结肠炎发生率、喂养不耐受发生率、住院时间.结果 观察组术后首次肠内营养时间显著短于对照组,住院期间体质量增加显著高于对照组,喂养不耐受发生率显著低于对照组(均P<0.05);两组全量经口喂养时间、住院时间、术后坏死性小肠结肠炎发生率比较,差异无统计学意义(均P>0.05).结论 基于肠道血氧饱和度监测指导高位肠闭锁患儿术后肠内营养,更有利于缩短术后首次肠内营养时间、减少喂养不耐受的发生,有利于患儿生长发育.
Effect of intestinal oxygenation monitoring in postoperative enteral nutrition of chil-dren with high intestinal atresia
Objective To explore the application effect of intestinal oxygenation monitoring in postoperative enteral nutrition of chil-dren with high intestinal atresia.Methods A total of 96 children with high intestinal atresia admitted to the department of neonatal surgery were selected as study subjects using convenience sampling.The children were divided into two groups based on admission time:the control group consisted of 48 children admitted from July 2018 to December 2020,and the observation group consisted of 48 children admitted from January 2021 to June 2023.Both groups received total parenteral nutrition support after surgery.In the control group,enteral nutrition was initiated according to the doctor's advice after 48 hours postoperation,and the feeding mode was adjusted based on tolerance during feeding.In the observation group,intestinal oxygenation monitoring was conducted imme-diately after surgery,and enteral nutrition commenced when the intestinal oxygenation value reached ≥0.77 after 24 hours.Ente-ral oxygenation was continuously monitored during feeding,and adjustments were made to enteral nutrition based on monitoring results.The first initiation time for enteral nutrition,total duration of oral feeding,body weight changes during hospitalization,incidence rates of necrotizing enterocolitis and feeding intolerance,as well as the length of hospital stay were observed.Results The first postoperative enteral nutrition time in the observation group was significantly lower than that in the control group,the in-crease of body mass during hospitalization was significantly higher than that in the control group,and the incidence of feeding into-lerance was significantly lower than that in the control group(all P<0.05).There was no significant difference in total oral feeding time,hospital stay and incidence of necrotizing enterocolitis between the two groups(all P>0.05).Conclusion The guidance of postoperative enteral nutrition based on intestinal oxygenation monitoring data is more conducive to shortening the first postoperative enteral nutrition time and reducing the occurrence of feeding intolerance,which is conducive to the growth and deve-lopment of children with high intestinal atresia.

intestinal atresiaintestinal oxygenationenteral nutritionoral feedingnecrotizing enterocolitisfeeding in-tolerancenursing care

张钰琪、乔春玲、刘丰丽、孙丽、周玉洁、缪雨蒙

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徐州医科大学附属徐州儿童医院新生儿外科(江苏徐州,221006)

肠闭锁 肠道血氧饱和度 肠内营养 经口喂养 坏死性小肠结肠炎 喂养不耐受 护理

徐州市科技计划基础研究面上项目

KC21057

2024

护理学杂志
华中科技大学同济医学院

护理学杂志

CSTPCD北大核心
影响因子:2.062
ISSN:1001-4152
年,卷(期):2024.39(10)