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危急病患者的胃肠道功能障碍:关于频率,严重程度,危险因素和结果的前性观察性研究. : 在危急疾病中的肠道功能障碍
Varsha M Asrani1, Colin McArthur2, Ian Bissett3
1Surgical and Translational Research (STaR) Centre, Department of Surgery, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Department of Nutrition and Dietetics, Auckland City Hospital, Auckland, New Zealand; Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand.
胃肠道功能障碍 (GD) 在重症监护室 (ICU) 很常见. 严重的GD与更长的ICU停留和机械通风相关,突出显示需要标准化评估以改善患者的治疗结果.
科学领域:
- 关键护理医学 关键护理医学
- 胃肠病学 胃肠病学
- 临床研究 临床研究
背景情况:
- 胃肠道功能障碍 (GD) 是重症监护室 (ICU) 患者经常出现的并发症.
- 关于GD对危急疾病严重程度和患者结局的影响仍在争论中.
- 这项研究旨在调查ICU患者中与GD相关的发病率,严重程度,风险因素和临床结果.
研究的目的:
- 为了确定在重症患者中胃肠功能障碍 (GD) 的频率和严重程度.
- 确定与GD发展相关的风险因素.
- 为了将GD严重程度与临床结果相关联,包括ICU停留时间,机械通风持续时间和死亡率.
主要方法:
- 对100名成年重症患者进行前性研究,预计ICU停留时间≥72小时.
- 使用急性胃肠损伤 (AGI) 和胃肠功能障碍评分 (GIDS) 进行胃肠疾病评估.
- 分析了GD,风险因素和临床结果之间的关联,使用后勤回归和混合效应模型.
主要成果:
- 所有患者都表现出至少一种胃肠道功能障碍的迹象/症状;100%患有AGI,79%患有GIDS.
- 严重的GD发生在46% (AGI) 和25% (GIDS) 的患者中,与肠道相关的入院诊断和乳酸水平升高有关.
- 严重的GD与更长时间的ICU住院和机械通风有关;液体平衡和肠道食影响了GD的严重程度.
结论:
- 持续评估GD对于临床决策在重症监护至关重要.
- 在ICU实践中迫切需要一种标准化,客观的GD评估方法.
- 及时识别和干预GD可能会改变临床结果.
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