神经危重症患者发生胃潴留的危险因素及干预对策

目的对我院神经内科病房收住的神经危重症发生胃潴留患者进行相关因素分析,并提出合理的干预对策。方法将我院近3a来在神经内科危重病房治疗的神经危重症并发生胃潴留的患者作为研究对象。通过胃插管为患者供给营养,时间〉1周,每隔6h将胃中的残留物抽取出来,根据胃中残留物的量是否超过200mL将患者分为胃潴留组23例和非胃潴留组49例。比较2组患者的一般情况和相关危险因素的差异。结果对2组患者在入院时登记的一般情况进行比较,发现患者在年龄、性别、血清蛋白等指标无明显差异,对其相关危险因素进行单因素分析,结果显示年龄、性别、机械通气、低血钾、高血糖、感染、低蛋白血糖、镇静、亚低温、离子絮乱与神经危重症患者发生胃潴留的关系相关性不高,而患者入院时格拉斯哥昏迷评分和胃潴留的发生相关性较强,且分数越低,胃潴留发生的可能性就越大,Logistic多因素分析结果显示格拉斯哥昏迷评分是其独立危险因素。结论神经危重症患者胃潴留的相关危险因素主要是格拉斯哥昏迷评分,且胃潴留的发生率和格拉斯哥昏迷评分、机械通气、亚低温和低血钾有着密切的关系,因此为防止神经危重症患者出现胃潴留,在治疗和护理期间应处理好相关干预对策,尽可能使患者降低病痛,也为临床护理提供一定的保障。

Analysis of risk factors and intervention measures of the gastric retention occurrence of patients with critically ill

Objective To investigate the risk factors and intervention measures of the gastric retention occurrence of patients with critically ill.Methods 52 patients with critically ill were divided into the gastric retention group（n=23）and the non-gastric retention（n=49）according to the amount of stomach residue more than 200 ml or not,and then the general condition and correlated risk factors of two groups were compared.Results Glasgow coma score of patients with critically admitted to hospital had clearer correlation with the occurrence of gastric retention,and the lower the glasgow coma score was and the larger the possibility of gastric retention.Logistic multivariate analysis showed that lower glasgow coma score was an independent risk factor for patients with critically ill.Conclusion Lower glasgow coma score is an independent risk factor for the gastric retention occurrence of patients with critically ill,and some positive intervention measures should be performed.