基于床旁超声的精准干预策略在ICU便秘患者中的应用研究

doi:10.3761/j.issn.0254-1769.2025.21.006

摘要/Abstract

摘要：

目的探讨基于床旁超声的精准干预策略在ICU便秘患者中的应用效果，为临床实践提供参考。方法选取2024年6月至2025年2月入住安徽省某三级甲等综合医院ICU的116例患者为研究对象，根据计算机随机生成的数字表，将患者分为试验组58例、对照组58例。试验组根据肠道超声评估结果给予精准的便秘干预策略，对照组给予常规的便秘处理措施。比较两组干预前及干预24 h后升结肠和降结肠的肠腔内径、干预后24 h内排便例次、干预后7 d内便秘和腹泻的发生率、干预后7 d腹围的差异。结果 19例因转科、自动出院、死亡等未完成该研究，最终共纳入97例，试验组47例，对照组50例。试验组在干预后升结肠、降结肠的肠腔内径分别为（1.49±0.39）（1.21±0.26）cm，均低于对照组（P<0.001）；试验组干预后24 h内排便41例次（87.23%）高于对照组的32例次（64.00%），干预后7 d内便秘和腹泻的发生率分别为8.51%、10.63%，均低于对照组的28.00%、32.00%（P<0.05）；干预后7 d试验组腹围低于对照组（P<0.05）。结论实施基于床旁超声的精准干预策略有助于ICU便秘患者大便的排出，降低再次便秘和腹泻的发生，并能缩小腹围，值得推广应用。

关键词: 超声, 便秘, 重症监护病房, 护理, 精准干预

Abstract:

Objective To explore the application of bedside ultrasound-based precise intervention strategies in ICU patients with constipation，to provide references for clinical practice. Methods A total of 116 patients admitted to the ICU of a tertiary general hospital in Anhui Province from June 2024 to February 2025 were selected and randomly divided into an intervention group with 58 cases and a control group with 58 cases by computer randomization. The intervention group was given precise intervention strategies based on the results of intestinal ultrasound assessment，while the control group received conventional constipation treatment measures. The differences in the intestinal diameters of the ascending and descending colon before and 24 hours after the intervention，the number of defecations within 24 hours after the first intervention，the incidence of constipation and diarrhea within 7 days after the intervention，and the abdominal circumference 7 days after the intervention were compared between the 2 groups. Results 19 patients did not complete the study due to transfer to other departments，voluntary discharge，or death. A total of 97 cases were ultimately included, comprising 47 cases in the experimental group and 50 cases in the control group. The intestinal diameters of the ascending and descending colon in the intervention group 24 hours after the intervention were（1.49±0.39） cm and（1.21±0.26） cm，respectively，which were lower than those in the control group（P<0.001）.The number of defecations within 24 hours after the intervention in the intervention group was 41 cases（87.23%）, higher than 32 cases in the control group（64.00%），and the incidence of constipation and diarrhea within 7 days after the intervention was 8.51%、10.63%，lower than 28.00%，32.00% in the control group（P<0.05）.The abdominal circumference 7 days after the intervention in the intervention group was lower than that in the control group（P<0.05）. Conclusion The precise intervention strategy based on bedside ultrasound is helpful for the defecation of ICU patients with constipation，reduces the incidence of constipation and diarrhea，and lowers abdominal circumference，and is worthy of promotion and application.

Key words: Ultrasound, Constipation, Intensive Care Units, Nursing Care, Precise Intervention

倪秀梅, 胡少华, 付红, 申小侠, 赵利灿, 张玉, 韩江英. 基于床旁超声的精准干预策略在ICU便秘患者中的应用研究[J]. 中华护理杂志, 2025, 60(21): 2599-2604.

NI Xiumei, HU Shaohua, FU Hong, SHEN Xiaoxia, ZHAO Lican, ZHANG Yu, HAN Jiangying. A study on the application of bedside ultrasound-based precise intervention strategies in ICU patients with constipation[J]. Chinese Journal of Nursing, 2025, 60(21): 2599-2604.

图/表 6

图1 ICU便秘患者床旁超声图像注：1a为直肠（没有大便），1b为直肠（少许大便), 1c为充盈的降结肠（繁星征，大量软便)，1d为充盈的升结肠（大量软便），1e为充盈升结肠（高回声少许干硬大便），1f为充盈的降结肠（低回声，水样大便），1g为充盈不足的降结肠，1h为充盈不足的升结肠。如果超声测量结肠直径≥5 cm，怀疑肠扩张，及时汇报医生。

Figure 1 Bedside ultrasound image of ICU constipation patients

图2 基于床旁超声的ICU便秘患者精准干预策略

Figure 2 Precision intervention strategy for ICU patients with constipation based on bedside ultrasound

表 1 两组一般资料的比较（n=97）

Table 1 Baseline information of participants in 2 groups（n=97）

表2 试验组干预前及干预24 h超声检查结果[n=47，例（百分比，%）]

Table 2 Ultrasound examination results in intervention group of patients before intervention and 24 hours after intervention[n=47，cases（percentage，%）]

表3 两组干预前及干预24 h后升结肠、降结肠的肠腔内径比较（cm，$\bar{x} \pm s$）

Table 3 Comparison of the diameters of the ascending colon and descending colon in the 2 groups before the intervention and 24 hours after intervention（cm，$\bar{x} \pm s$）

表4 两组干预后排便例次及便秘、腹泻发生率的比较[例（百分比，%）]

Table 4 Comparison of the number of defecation cases and the incidence of constipation and diarrhea in the 2 groups after intervention[cases（percentage，%）]

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