Objective To explore the effect of bedside ultrasound in measuring gastric residual volume in neurosurgical critical patients with enteral nutrition support .Method From March to August 2016,70 critically neurological patients with continues enteral nutrition who admitted in Intensive Care Unit ( ICU) were randomized into two groups .The observation group applied the bedside ultrasound monitoring gastric residual volume every day to guide the implementation of enteral nutrition .The control group used syringes withdrawing every 8 hours to measure the gastric residual volume . Results There was no statistically significant difference in the incidence of complications include regurgitation and aspiration in this two group patients (P=0.356;P=1.000), while the times of interrupting enteral nutrition was lower in the observation group(25.7%vs 5.7%,74.3% vs 94.3%,P=0.045), the length of target feeding time and the length of ICU stay, the operation time was shortened, with a statistically significant difference[(2.37 ± 0.69) d vs (3.49 ±0.74) d,P=0.028;(8.52 ±5.45) d vs (6.40 ±2.71) d,P=0.022;(58.29 ± 11.22)s vs (67.60 ±7.05) s,P=0.000].Conclusion The application of bedside ultrasound to measure gastric residual volume can be a scientific method to guide enteral nutrition in neurosurgical critical patients , which can reduce the times of interrupting enteral nutrition and shorten the length of target feeding time and ICU length of stay ,reduce the workload of nurses .%目的 探讨床旁超声监测胃残余量在神经外科重症患者肠内营养中的应用效果.方法 2016年3至8月中南大学湘雅医院重症医学科(ICU)的70例行持续肠内营养的神经重症患者,数字表法随机分为2组,观察组采取床旁超声监测胃残余量,每天监测1次,指导肠内营养实施;对照组采用注射器回抽法每8小时监测胃残余量进而调整肠内营养方案.结果 两组患者在胃内容物反流、误吸等并发症发生率方面差异无统计学意义(P=0.356;P=1.000),观察组肠内营养中断率低于对照组(25.7%比5.7%,74.3%比94.3%,P=0.045),观察组肠内营养达到目标喂养量时间、住ICU时间、操作时间较对照组明显缩短[(2.37±0.69)d比(3.49±0.74)d,P=0.028;(8.52±5.45)d比(6.40±2.71)d,P=0.022;(58.29±11.22)s比(67.60±7.05)s,P=0.000].结论 床旁超声监测胃残余量可以更科学地指导神经外科重症患者肠内营养方案,减少肠内营养中断率,更快地达到目标喂养量,缩短ICU住院时间,减轻了护士的工作量.
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