摘要
目的评价肠道血氧饱和度监测在高位肠闭锁患儿术后肠内营养中的应用效果。方法采用便利抽样法,选取入住新生儿外科的96例高位肠闭锁患儿为研究对象,根据入住时间将患儿分为两组,2018年7月至2020年12月入住的48例患儿分为对照组,2021年1月至2023年6月入住的48例分为观察组。两组术后给予全肠外营养支持,对照组术后48 h后遵医嘱开始实施肠内营养,喂养期间根据喂养耐受情况调整喂养方式。观察组术后即进行肠道血氧饱和度监测,24 h后若肠道血氧饱和度≥0.77时开始进行肠内营养,喂养期间持续监测肠道血氧饱和度,根据监测结果调整肠内营养。观察两组术后首次肠内营养时间、全量经口喂养时间、体质量、坏死性小肠结肠炎发生率、喂养不耐受发生率、住院时间。结果观察组术后首次肠内营养时间显著短于对照组,住院期间体质量增加显著高于对照组,喂养不耐受发生率显著低于对照组(均P<0.05);两组全量经口喂养时间、住院时间、术后坏死性小肠结肠炎发生率比较,差异无统计学意义(均P>0.05)。结论基于肠道血氧饱和度监测指导高位肠闭锁患儿术后肠内营养,更有利于缩短术后首次肠内营养时间、减少喂养不耐受的发生,有利于患儿生长发育。
Objective To explore the application effect of intestinal oxygenation monitoring in postoperative enteral nutrition of children with high intestinal atresia.Methods A total of 96 children with high intestinal atresia admitted to the department of neonatal surgery were selected as study subjects using convenience sampling.The children were divided into two groups based on admission time:the control group consisted of 48 children admitted from July 2018 to December 2020,and the observation group consisted of 48 children admitted from January 2021 to June 2023.Both groups received total parenteral nutrition support after surgery.In the control group,enteral nutrition was initiated according to the doctor′s advice after 48 hours postoperation,and the feeding mode was adjusted based on tolerance during feeding.In the observation group,intestinal oxygenation monitoring was conducted immediately after surgery,and enteral nutrition commenced when the intestinal oxygenation value reached≥0.77 after 24 hours.Ente-ral oxygenation was continuously monitored during feeding,and adjustments were made to enteral nutrition based on monitoring results.The first initiation time for enteral nutrition,total duration of oral feeding,body weight changes during hospitalization,incidence rates of necrotizing enterocolitis and feeding intolerance,as well as the length of hospital stay were observed.Results The first postoperative enteral nutrition time in the observation group was significantly lower than that in the control group,the increase of body mass during hospitalization was significantly higher than that in the control group,and the incidence of feeding into-lerance was significantly lower than that in the control group(all P<0.05).There was no significant difference in total oral feeding time,hospital stay and incidence of necrotizing enterocolitis between the two groups(all P>0.05).Conclusion The guidance of postoperative enteral nutrition based on intestinal oxygenation monitoring data is more conducive to shortening the first postoperative enteral nutrition time and reducing the occurrence of feeding intolerance,which is conducive to the growth and deve-lopment of children with high intestinal atresia.
作者
张钰琪
乔春玲
刘丰丽
孙丽
周玉洁
缪雨蒙
Zhang Yuqi;Qiao Chunling;Liu Fengli;Sun Li;Zhou Yujie;Miu Yumeng(Department of Neonatal Surgery,The Affiliated Xuzhou Children′s Hospital of Xuzhou Medical University,Xuzhou 221006,China)
出处
《护理学杂志》
CSCD
北大核心
2024年第10期113-115,120,共4页
Journal of Nursing Science
基金
徐州市科技项目基础研究面上项目(KC21057)。
关键词
肠闭锁
肠道血氧饱和度
肠内营养
经口喂养
坏死性小肠结肠炎
喂养不耐受
护理
intestinal atresia
intestinal oxygenation
enteral nutrition
oral feeding
necrotizing enterocolitis
feeding intolerance
nursing care
