河北医科大学学报

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河北省危重患者急性胃肠功能损伤调查

  

  1. 1.河北省人民医院重症医学科,河北 石家庄 050051;2.中国人民解放军第二五二医院肿瘤血液科,河北 保定 071000;
    3.河北省石家庄市第三医院老年科;河北 石家庄 050011
  • 出版日期:2017-12-25 发布日期:2017-12-19
  • 作者简介:任珊(1983-),女,山西昔阳人,河北省人民医院主治医师,医学博士,从事危重症诊治研究。
  • 基金资助:
    河北省医学科学研究重点课题(20150119)

Investigation of acute gastrointestinal injury in critically ill patients in Hebei

  1. 1.Department of Intensive Care Unit, Hebei General Hospital, Shijiazhuang 050051, China;
    2.Department of Oncology and Hematology, No.252 Hospital of Chinese People′s Liberation
    Army, Hebei Province, Baoding 071000, China; 3.Department of Gerontology, the Third
    Hospital of Shijiazhuang, Hebei Province, Shijiazhuang 050011, China
  • Online:2017-12-25 Published:2017-12-19

摘要: [摘要]〓
〖HTH〗目的〖HTSS〗〖KG*2〗了解河北省重症患者急性胃肠功能损伤及其干预情况,寻找实践与指南间的差距,制定有效的方案和改进措施。
〖HTH〗方法〖HTSS〗〖KG*2〗收集河北省25所三级甲等医院重症医学科(intensive care unit,ICU)收治的320例重症患者的病例资料,采用问卷调查方式,收集患者一般资料、疾病类型、急性生理与慢性健康评分、序贯器官衰竭估计评分、住院时间、住ICU时间、ICU病死率、28 d病死率和急性胃肠功能损伤分级等指标。
〖HTH〗结果〖HTSS〗〖KG*2〗营养调查对207例(64.7%)接受肠内营养的重症患者进行了急性胃肠功能损伤等级评估,Ⅰ级125例(60.4%),Ⅱ级55例(26.6%),Ⅲ级22例(10.6%),Ⅳ级5例(2.4%)。临床营养实践与指南推荐意见之间存在着较大差距。
〖HTH〗结论〖HTSS〗〖KG*2〗重症医师应提高对急性胃肠功能损伤的重视程度,加强对急性胃肠损伤相关指南的学习和培训,将指南与个体化治疗相结合。

关键词: 危重病, 急性胃肠损伤, 营养支持

Abstract: [Abstract] Objective〖HTSS〗〓To investigate acute gastrointestinal injury(AGI) in critically ill patients in Hebei, to find out the differences between practice and guideline,to formulate the effective protocol and improvement measures.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Threehundred and twenty critically ill patients were included in 25 intensive care units of tertiary hospital of Hebei province. A database of information was built from questionnaires, which included characteristics of patients, types of diseases, Acute Physiology and Chronic Health Evaluation Ⅱ score,Sequential Organ Failure Assessment score, length of stay, length of ICU stay, mortality in ICU and at 28 days, the severity of AGI and so on.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓A total of 207 critically ill patients who were received enteral nutrition was enrolled in the survey to assess the severity of AGI. It is found that AGI grade Ⅰ accounted for 60.4%. AGI grade Ⅱ accounted for 26.6%. AGI gradeⅢaccounted for 10.6%. AGI gradeⅣaccounted for 2.4%. There was a great distance between clinical nutritional practice and guideline recommendation.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Physician should improve the degree of recognition for acute gastrointestinal injury and enhance study and training for the guideline of acute gastrointestinal injury, combine the guideline with individualized treatment.

Key words: critical illness, acute gastrointestinal injury, nutritional support