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目的评价对急性胃肠损伤(AGI)患者进行早期肠康复的效果,提出进一步完善的意见。方法调查住院危重患者AGI的发病和肠内营养的使用情况及其效果,患者涉及ICU、神经外科、胸外科等,患者未行胃肠道手术。早期将各种必需的药物与营养制剂,通过肠内途径应用于需要营养治疗的患者,促进肠道多种功能的代偿,改善肠黏膜屏障作用、减少肠内毒素和细菌的易位,满足机体对营养物质的需要。结果 56名危重患者在急性疾病阶段及时进行了肠康复治疗,促进患者顺利渡过危急病情。经严格统计分析后认为效果满意。早期肠康复对术后并发症起到了预防作用。除提供机体能量外,在维护肠功能、改善肠黏膜屏障、减少肠内毒素、阻止细菌易位、调节肠道微生态和降低肠源性感染等方面也起到了较好的作用。患者的胃内容物一次抽吸量平均为(280.00±10.17)ml/d。所有患者未发生喂食物误吸。结论 AGI患者应及早进行肠康复治疗和护理,胃内容物一次抽吸的定量管理对临床选择肠内营养的时机有较好的指导意义。急性胃肠损伤新概念的提出和分级管理有利于危重患者的康复,对肠内营养的剂量和逐步增加的时限应进一步研究。
Objective To evaluate the effect of early intestine rehabilitation on patients with acute gastrointestinal injury (AGI) and to put forward further suggestions. Methods The incidence and effect of AGI and enteral nutrition in hospitalized critically ill patients were investigated. The patients involved in ICU, neurosurgery and thoracic surgery were not undergone gastrointestinal surgery. Early all kinds of necessary drugs and nutritional agents, through the enteral route for patients in need of nutrition treatment, promote the compensatory multiple functions of the intestine, improve intestinal barrier function, reduce intestinal endotoxin and bacterial translocation, meet Body needs of nutrients. Results Fifty-six critically ill patients underwent timely enteric rehabilitation in the acute stage of the disease, which facilitated the successful passage of the critical condition. After a rigorous statistical analysis that the results are satisfactory. Early enteric rehabilitation on postoperative complications played a preventive role. In addition to providing body energy, it also plays a good role in maintaining bowel function, improving intestinal mucosal barrier, reducing intestinal endotoxin, preventing bacterial translocation, regulating intestinal microflora and reducing intestinal infection. The average amount of gastric contents once inhaled was (280.00 ± 10.17) ml / d. All patients did not happen to feed the food aspiration. Conclusion AGI patients should be treated with intestinal rehabilitation and nursing as soon as possible. The quantitative management of one-time suction of gastric contents has a good guiding significance for the timing of clinical enteral nutrition selection. The new concept of acute gastrointestinal injury proposed and graded management is conducive to the rehabilitation of critically ill patients, the dose of enteral nutrition and gradually increase the time limit should be further studied.