Clinical value of gastroantrum cross-sectional area to guide enteral nutri-tion in elderly patients with severe disease
Objective To explore the clinical value of applying the cross-sectional area of gastric antrum to guide enteral nutrition in elderly patients with severe disease.Methods A total of 236 elderly patients(aged≥65 years)who were hospi-talized in the Department of Intensive Care Medicine of Lanzhou First People's Hospital from January 2020 to December 2022 were selected as the study objects.The study objects were assigned serial numbers according to the order of hospital-ization,and were divided into groups with odd numbers as the ultrasound group(118 cases),even numbers were taken as routine group(118 cases).In the ultrasound group,enteral nutrition support treatment was guided by the cross-sectional area of the antrum.When the cross-sectional area of the antrum was greater than 709.2 mm2,enteral nutrition was stopped for 4 h and then measured.When the cross-sectional area of the antrum was less than 709.2 mm2,enteral nutrition was performed again.In the conventional group,enteral nutri-tion support therapy was guided by gastric residual volume.When gastric residual volume was ≥200 ml,enteral nu-trition was stopped for 4 h,and then gastric residual vol-ume was measured.If it was significantly reduced,enteral nutrition was performed again.The serum albumin,enteral nutrition,enteral nutrition standard time,ICU stay time,total hospitalization cost and mortality of the two groups were compared,and the incidence of feeding interruption rate,regurgita-tion,aspiration,diarrhea,liver insufficiency,gastrointestinal bleeding and intestinal obstruction were compared between the two groups.Results There were no significant differences in serum albumin and enteral nutrition between the two groups before treatment(P＞0.05).The serum albumin of the two groups on the 7th day of treatment was higher than that on the 5th day,the serum albumin of the 5th day was higher than that on the 3rd day,and the serum albumin of the 3rd day was higher than that on the 1st day,with statistical significance(P＜0.05).The serum albumin of ultrasound group at 1st,3rd,5th and 7th day was higher than that of conventional group,and the difference was statistically significant(P＜0.05).The enteral nutri-tion amount on the 7th day of treatment in two groups was higher than that on the 5th day,the enteral nutrition amount on the 5th day was higher than that on the 3rd day,the enteral nutrition amount on the 3rd day was higher than that on the 2nd day,and the enteral nutrition amount on the 2nd day was higher than that on the 1st day,the differences were statistically significant(P＜0.05).The enteral nutrition in ultrasound group at the 1st,2ndd,3rd,5th and 7th day was higher than that in conventional group,and the difference was statistically significant(P＜0.05).The feeding interruption rate,incidence of intestinal ob-struction,mortality and total hospitalization cost in ultrasound group were lower than those in conventional group,and the time to reach the standard of enteral nutrition was shorter than that in conventional group,the differences were statistically significant(P＜0.05).There were no significant differences in the incidence of reflux,aspiration,diarrhea,liver insufficiency and gastrointestinal bleeding between the two groups(P＞0.05).The total incidence of complications in ultrasound group was lower than that in conventional group,and the difference was statistically significant(P＜0.05).Conclusion It has important clinical value to guide the enteral nutrition support treatment of elderly patients with severe diseases through the cross-sectional area of the gastric antrum,which can achieve the feeding goal faster,improve hypoproteinemia earlier,re-duce the rate of feeding interruption,reduce the occurrence of various complications,reduce the total hospitalization cost and mortality,and provide certain clinical theoretical basis for the enteral nutrition support treatment of elderly patients with severe diseases.
万方数据
维普
