机械通气患者急性胃肠损伤分级管理方案的构建及应用效果评价

doi:10.3761/j.issn.2096-7446.2025.03.002

摘要/Abstract

摘要：

目的探究急性胃肠损伤（acute gastrointestinal injury，AGI）分级管理方案在机械通气患者中的应用效果。方法构建机械通气患者急性胃肠损伤分级管理方案。采用连续抽样法，选取2023年5月—12月在ICU接受有创机械通气的患者76例，采用SPSS 25.0软件生成的随机数列将研究对象随机分为试验组38例，对照组38例。试验组给予AGI分级管理，对照组给予常规护理，比较两组在脱机及转出ICU时的胃肠功能及营养状况。结果脱机及转出ICU时，试验组AGI严重程度评分低于对照组（P<0.05），且白蛋白计数高于对照组（P<0.05）；转出ICU时，试验组血红蛋白计数高于对照组（P<0.05），且营养风险筛查评分低于对照组（P<0.05）；ICU住院期间，试验组AGI持续时间、肠内营养中断率及胃动力药物使用率均低于对照组（P<0.05）。结论 AGI分级管理可有效减轻患者机械通气期间的胃肠道损伤严重程度，改善胃动力及营养状态，对促进患者康复具有重要意义。

关键词: 机械通气, 急性胃肠损伤, 分级管理, 护理

Abstract:

Objective To explore the application effect of graded management scheme for acute gastrointestinal injury（AGI） in patients with mechanical ventilation. Methods A total of 76 patients who received invasive mechanical ventilation in the intensive care unit from May 2023 to December 2023 were selected by continuous sampling method. The subjects were randomly divided into the experimental group（38 cases） and the control group （38 cases） using the random sequence generated by SPSS 25.0 software. The experimental group was given AGI graded management，and the control group was given routine nursing. The gastrointestinal function and nutritional status of the two groups were compared when they were offline and transferred out of ICU. Results Compared with the control group，the experimental group had a significantly lower AGI severity score and a significantly higher albumin count at weaning and ICU discharge（P<0.05）. At ICU discharge，the hemoglobin count of the experimental group was higher than that of the control group（P<0.05），and the nutritional risk screening score was lower than that of the control group（P<0.05）. During ICU stay，the experimental group had significantly lower AGI duration，enteral nutrition interruption rate，and gastric motility drug use rate than the control group（P<0.05）. Conclusion Graded management of acute gastrointestinal injury can effectively reduce the severity of gastrointestinal injury during mechanical ventilation，improve gastric motility and nutritional status，and is of great significance to promote the recovery of patients.

Key words: Mechanical Ventilation, Acute Gastrointestinal Injury, Hierarchical Management, Nursing Care

张梓靖, 郑剑煌, 陈玉珍, 姜志钊, 康珍珍, 张龙雨. 机械通气患者急性胃肠损伤分级管理方案的构建及应用效果评价[J]. 中华急危重症护理杂志, 2025, 6(3): 268-274.

ZHANG Zijing, ZHENG Jianhuang, CHEN Yuzhen, JIANG Zhizhao, KANG Zhenzhen, ZHANG Longyu. The application effect of acute gastrointestinal injury graded management scheme in mechanical ventilated patients[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(3): 268-274.

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