【摘要】 目的探讨胃窦运动指数(MI)和肠系膜上动脉时间平均流速(TAMV)与重症患者急性胃肠道损伤(AGI)程度的相关性。方法选取2018年1月至2019年6月广西壮族自治区人民医院EICU收治的73例重症患者,收集患者临床基础资料,使用彩色多普勒超声动态监测MI、TAMV,收集患者SOFA评分、腹腔内压、血乳酸等相关指标。根据有无AGI及AGI分级标准,分为非AGI组(28例),AGI I级组(15例)、Ⅱ级组(20例)、Ⅲ级组(10例),进行组间比较。采用Spearman相关分析MI和TAMV与AGI严重程度的相关性。结果共纳入重症患者73例,发生AGI45例,未发生AGI 28例。①单因素方差分析(ANOVA)结果显示,TAMV随AGI分级增加而递减,SOFA评分与AGI分级增加而递增;②Spearman相关分析显示,TAMV、MI及SOFA评分与AGI分级强相关(r=-0.856、-0.768、0.709,P <0.01),血乳酸与AGI分级呈中等相关(r=0.669,P<0.01);APACHEⅡ评分与AGI分级呈弱相关(r=0.298,P<0.05)。结论 MI及TAMV与重症患者发生AGI及AGI分级具有相关性,可作为诊断AGI及分级的依据之一。更多还原

【Abstract】 Objective To investigate the correlation of acute gastrointestinal injury(AGI) with motility index(MI),time averaged mean velocity(TAMV) of superior mesenteric artery in critically ill patients.Methods 73 critically ill patients were selected from emergency department of Guangxi Zhuang Autonomous Region People’s Hospital from January 2018 to June 2019.Patients’ general information and AGI characteristics were assessed.Then,all the participants were divided into two groups(AGI group and non-AGI group and AGI group was divided into four subgroups(AGI I,AGI Ⅱ,AGIⅢ,AGI Ⅳ).The correlation of AGI degree with MI and TAMV was analyzed by Spearman test.Results A total of 73 critical patients were enrolled including 45 patients with AGI and 28 without AGI.①ANOVA analysis found that TAMV decreased with increased level of AGI,sequential organ failure assessment(SOFA) was increased with increased level of AGI.②Spearman test showed there was strong correlation between AGI degree and other indexes including TAMV,MI and SOFA(r=-0.856,-0.768,0.709,P <0.01),moderate correlation with blood lactic acid level(r=0.669,P <0.01),weak correlation with acute physiology and chronic health evaluation system Ⅱ(APACHE Ⅱ)(r=0.298,P <0.05).Conclusion MI and TAMV are have a certain predictive value for AGI patients with mechanical ventilation,and two indexes has correlation with AGI in critically ill patients.Combined application can provide a certain objective basis for clinical AGI diagnosis.更多还原