超声结合多模态数据预测ICU老年患者胃肠功能障碍风险新进展
Recent Advances in Ultrasonography Combined with Multimodal Data for Predicting Gastrointestinal Dysfunction Risk in Elderly ICU
摘要: 重症监护病房老年患者胃肠功能障碍发病率高、预后差，早期精准预测是改善结局的关键。超声技术因实时、无创、可重复等优势，在胃肠道功能评估中应用广泛。本文系统综述超声联合多模态数据在预测ICU老年患者GID风险中的研究进展，探讨现有评分系统的应用价值、超声技术的优势与局限，以及多维度数据融合模型的构建方向，为临床早期干预提供理论依据。
Abstract: Elderly patients in intensive care units (ICUs) exhibit high incidence and poor prognosis of gastrointestinal dysfunction, making early accurate prediction crucial for improving outcomes. Ultrasonography, due to its real-time, non-invasive, and reproducible advantages, is widely used in gastrointestinal function assessment. This article systematically reviews research progress on ultrasonography combined with multimodal data for predicting gastrointestinal dysfunction (GID) risk in elderly ICU patients, examines the clinical value of existing scoring systems, discusses the strengths and limitations of ultrasonography, and outlines approaches for constructing multidimensional data fusion models, thereby providing a theoretical foundation for early clinical intervention.
文章引用：龚乃琪. 超声结合多模态数据预测ICU老年患者胃肠功能障碍风险新进展[J]. 护理学, 2026, 15(5): 194-203. https://doi.org/10.12677/ns.2026.155159

参考文献

[1] Dumic, I., Nordin, T., Jecmenica, M., Stojkovic Lalosevic, M., Milosavljevic, T. and Milovanovic, T. (2019) Gastrointestinal Tract Disorders in Older Age. Canadian Journal of Gastroenterology and Hepatology, 2019, Article ID: 6757524. [Google Scholar] [CrossRef] [PubMed]
[2] 孙桂楠, 田金金, 张雪琴, 等. 脓毒症急性胃肠功能损伤及相关生物标志物的研究进展[J]. 临床急诊杂志, 2025, 26(4): 287-292.
[3] Reintam Blaser, A., Malbrain, M.L.N.G., Starkopf, J., Fruhwald, S., Jakob, S.M., De Waele, J., et al. (2012) Gastrointestinal Function in Intensive Care Patients: Terminology, Definitions and Management. Recommendations of the ESICM Working Group on Abdominal Problems. Intensive Care Medicine, 38, 384-394. [Google Scholar] [CrossRef] [PubMed]
[4] 李妙芬. 危重症患者胃肠功能评估的研究进展[J]. 智慧健康, 2020, 6(10): 72-74.
[5] 张茹, 邬媛, 宏欣, 等. 急性呼吸衰竭患者发生胃肠功能障碍的危险因素及预测模型的构建分析[J]. 疑难病杂志, 2023, 22(7): 725-729, 734.
[6] 石丽, 夏茂玲, 严茜, 等. 老年结直肠癌术后胃肠功能障碍的影响因素及预测模型[J]. 局解手术学杂志, 2023, 32(10): 906-910.
[7] 亚洲急危重症协会中国腹腔重症协作组. 重症病人胃肠功能障碍肠内营养专家共识(2021版) [J]. 中华消化外科杂志, 2021, 20(11): 1123-1136.
[8] 米元元, 黄海燕, 尚游, 等. 中国危重症患者肠内营养支持常见并发症预防管理专家共识 (2021版) [J]. 中华危重病急救医学, 2021, 33(8): 897-912.
[9] Kouw, I.W.K., Melchers, M., Mändul, M., Arabi, Y.M., Casaer, M.P., Cotoia, A., et al. (2024) Prospective Multicenter Study to Validate the Gastrointestinal Dysfunction Score (GIDS) in Intensive Care Patients: Study Protocol for Part a of the International GUTPHOS Study. Clinical Nutrition ESPEN, 63, 702-708. [Google Scholar] [CrossRef] [PubMed]
[10] Liu, X., Wang, Q., Yang, D., Fu, M., Yang, M., Bi, Y., et al. (2023) Association between Gastrointestinal Dysfunction Score (GIDS) and Disease Severity and Prognosis in Critically Ill Patients: A Prospective, Observational Study. Clinical Nutrition, 42, 700-705. [Google Scholar] [CrossRef] [PubMed]
[11] Lai, J., Chen, S., Chen, L., Huang, D., Lin, J. and Zheng, Q. (2022) Bedside Gastrointestinal Ultrasound Combined with Acute Gastrointestinal Injury Score to Guide Enteral Nutrition Therapy in Critically Patients. BMC Anesthesiology, 22, Article No. 231. [Google Scholar] [CrossRef] [PubMed]
[12] Perez-Calatayud, A.A., Carrillo-Esper, R., Anica-Malagon, E.D., Briones-Garduño, J.C., Arch-Tirado, E., Wise, R., et al. (2018) Point-of-Care Gastrointestinal and Urinary Tract Sonography in Daily Evaluation of Gastrointestinal Dysfunction in Critically Ill Patients (GUTS Protocol). Anestezjologia Intensywna Terapia, 50, 40-48. [Google Scholar] [CrossRef] [PubMed]
[13] Brotfain, E., Erblat, A., Luft, P., Elir, A., Gruenbaum, B.F., Livshiz-Riven, I., et al. (2022) Nurse-Performed Ultrasound Assessment of Gastric Residual Volume and Enteral Nasogastric Tube Placement in the General Intensive Care Unit. Intensive and Critical Care Nursing, 69, Article ID: 103183. [Google Scholar] [CrossRef] [PubMed]
[14] Bharucha, A.E., Kudva, Y.C. and Prichard, D.O. (2019) Diabetic Gastroparesis. Endocrine Reviews, 40, 1318-1352. [Google Scholar] [CrossRef] [PubMed]
[15] Teng, J., Xiang, L., Long, H., Gao, C., Lei, L. and Zhang, Y. (2021) The Serum Citrulline and D-Lactate Are Associated with Gastrointestinal Dysfunction and Failure in Critically Ill Patients. International Journal of General Medicine, 14, 4125-4134. [Google Scholar] [CrossRef] [PubMed]
[16] Yan, Y., Chen, Y. and Zhang, X. (2021) The Effect of Opioids on Gastrointestinal Function in the ICU. Critical Care, 25, Article No. 370. [Google Scholar] [CrossRef] [PubMed]
[17] Danielis, M., Mattiussi, E., Piani, T., Iacobucci, A., Tullio, A., Molfino, A., et al. (2023) Diarrhoea and Constipation during Artificial Nutrition in Intensive Care Unit: A Prospective Observational Study. Clinical Nutrition ESPEN, 57, 375-380. [Google Scholar] [CrossRef] [PubMed]
[18] Huang, H., Wang, T., Yao, S., Lin, P., Chang, J.C., Peng, L., et al. (2022) Gastric Mobility and Gastrointestinal Hormones in Older Patients with Sarcopenia. Nutrients, 14, Article No. 1897. [Google Scholar] [CrossRef] [PubMed]
[19] Preiser, J., Arabi, Y.M., Berger, M.M., Casaer, M., McClave, S., Montejo-González, J.C., et al. (2021) A Guide to Enteral Nutrition in Intensive Care Units: 10 Expert Tips for the Daily Practice. Critical Care, 25, Article No. 424. [Google Scholar] [CrossRef] [PubMed]
[20] McClave, S.A., Gualdoni, J., Nagengast, A., Marsano, L.S., Bandy, K. and Martindale, R.G. (2020) Gastrointestinal Dysfunction and Feeding Intolerance in Critical Illness: Do We Need an Objective Scoring System? Current Gastroenterology Reports, 22, Article No. 1. [Google Scholar] [CrossRef] [PubMed]
[21] Reintam Blaser, A., Padar, M., Mändul, M., Elke, G., Engel, C., Fischer, K., et al. (2021) Development of the Gastrointestinal Dysfunction Score (GIDS) for Critically Ill Patients—A Prospective Multicenter Observational Study (iSOFA Study). Clinical Nutrition, 40, 4932-4940. [Google Scholar] [CrossRef] [PubMed]
[22] Alsharqawi, N., Alhashemi, M., Kaneva, P., Baldini, G., Fiore, J.F., Feldman, L.S., et al. (2019) Validity of the I-FEED Score for Postoperative Gastrointestinal Function in Patients Undergoing Colorectal Surgery. Surgical Endoscopy, 34, 2219-2226. [Google Scholar] [CrossRef] [PubMed]
[23] 潘朝勇, 曾汇霞, 吴家圣, 等. 急性胃肠损伤分级联合多因素评估对危重患者死亡的预测价值[J]. 中国当代医药, 2020, 27(26): 8-11, 253.
[24] Hill, T.L. (2019) Gastrointestinal Tract Dysfunction with Critical Illness: Clinical Assessment and Management. Topics in Companion Animal Medicine, 35, 47-52. [Google Scholar] [CrossRef] [PubMed]
[25] Parkman, H.P., Van Natta, M.L., Maurer, A.H., Koch, K.L., Grover, M., Malik, Z., et al. (2022) Postprandial Symptoms in Patients with Symptoms of Gastroparesis: Roles of Gastric Emptying and Accommodation. American Journal of Physiology-Gastrointestinal and Liver Physiology, 323, G44-G59. [Google Scholar] [CrossRef] [PubMed]
[26] Padar, M., Starkopf, J., Uusvel, G. and Reintam Blaser, A. (2019) Gastrointestinal Failure Affects Outcome of Intensive Care. Journal of Critical Care, 52, 103-108. [Google Scholar] [CrossRef] [PubMed]
[27] Reintam Blaser, A., Bachmann, K.F. and Deane, A.M. (2023) Gastrointestinal Function in Critically Ill Patients. Current Opinion in Clinical Nutrition & Metabolic Care, 26, 463-469. [Google Scholar] [CrossRef] [PubMed]
[28] 杨佳, 庄则豪. 内镜超声检查在消化道出血诊治中的应用研究[J]. 微创医学, 2019, 14(4): 479-482.
[29] 周新艺, 邓海波, 孙建华, 等. 护士在重症患者胃肠功能障碍精准化管理中的作用[J]. 中华急危重症护理杂志, 2024, 5(10): 957-996
[30] 吴苑华, 李乾, 吴晓丹, 等. 胃肠道超声在炎症性肠病中的应用现状与进展[J]. 影像技术, 2024, 36(6): 76-80.
[31] 唐蕾, 王滟, 杨旭, 等. 人工智能在超声辅助诊断中的应用[J]. 实用医院临床杂志, 2025, 22(2): 180-184.
[32] 赵浩天, 龙玲, 任珊, 等. 超声监测胃残余量对肠内营养实施的指导和评估新进展[J]. 肠外与肠内营养, 2020, 27(1): 56-60.
[33] Vijayvargiya, P., Jameie-Oskooei, S., Camilleri, M., Chedid, V., Erwin, P.J. and Murad, M.H. (2018) Association between Delayed Gastric Emptying and Upper Gastrointestinal Symptoms: A Systematic Review and Meta-Analysis. Gut, 68, 804-813. [Google Scholar] [CrossRef] [PubMed]
[34] 赵明曦, 孙建华, 李奇, 等. 床旁超声评估重症患者胃肠功能的最佳证据总结[J]. 中华现代护理杂志, 2022, 28(5): 602-610.
[35] 中国医师协会肛肠医师分会(2024). 慢性便秘检查与评估中国专家共识(2024版) [J]. 中华胃肠外科杂志, 2024, 27(12): 1191-1201.
[36] 熊盟, 靳鑫, 杨艳, 等. 羟考酮对机械通气的中重度急性呼吸窘迫综合征患者胃肠道功能的影响[J]. 中国临床药理学与治疗学, 2024, 29(11): 1300-1305.
[37] 孙建华, 张青, 李欣, 等. 重症超声临床操作技术的护理规范[J]. 中华现代护理杂志, 2023, 29(16): 2101-2112.
[38] Pérez-Calatayud, A.A., Carrillo-Esper, R., Carrillo-Torres, O., Fareli-Gónzalez, C., Peña-Pérez, C., Meza-Marquez, J.M., et al. (2022) Ultrasound Meal Accommodation Test in Critically Ill Patients with and without Feeding Intolerance UMAT-ICU. Clinical Nutrition ESPEN, 51, 424-429. [Google Scholar] [CrossRef] [PubMed]

为你推荐