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Objective:To investigate the clinical effect of intra-abdominal pressure monitoring on jejunal nutrition in critically ill patients.Methods:From March 2017 to September 2018, 124 critically ill patients who needed early jejunal nutrition in ICU of our hospital were selected and randomly divided into observation group (63 cases) and control group (61 cases) according to the digital table.The observation group adjusted enteral nutrition according to IAP monitoring, while the control group was routinely observed and guided enteral nutrition.Intra-abdominal pressure was compared between the two groups.The changes of blood lactic acid, endotoxin and APACHE Ⅱ score were compared between the two groups.Results:After treatment for 7 days and 14 days, the intra-abdominal pressure of the observation group[(14.28±2.36)mmHg, (12.08±1.78)mmHg] were lower than those of the control group [(16.05±2.55)mmHg and (15.21±2.11)mmHg] ( t=4.013, 8.939, all P<0.05). After treatment for 14 days, the blood lactic acid, endotoxin, APACHE Ⅱ score in the observation group were (2.19±0.73)mmol/L, (0.71±0.21)U/L and (10.02±1.54), which were lower than those in the control group [(3.98±0.95)mmol/L, (0.92±0.23)U/L and (13.06±1.72)] ( t=11.788, 5.313, 10.376, all P<0.05). The incidences of abdominal distension (9.52%) and gastric retention (7.94%) in the observation group were significantly lower than those in the control group (28.57%, 27.87%) (χ 2=7.930, 8.437, all P<0.05). Conclusion:Early jejunal nutrition under the monitoring of intra-abdominal pressure in critically ill patients can help to reduce intra-abdominal hypertension, promote the rehabilitation of patients, reduce the incidence of complications of jejunal nutrition and improve patients’ tolerance, which is worthy of clinical promotion.
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Objective To evaluate the application of serological detection of Chlamydia pneumonia (Cpn) in patients with acute coronary syndrome (ACS) .Methods From Oct .2012 to Oct .2013 ,80 patients with ACS (ACS group) and 80 healthy subjects (control group) were enrolled and detected for Cpn DNA .According to the detected results ,ACS patients were divided to chlamydia group and non‐chlamydia group .Serum levels of tumor necrosis factor α(TNF‐α) ,C reaction protein (CRP) ,intercellular cell adhe‐sion molecule‐1 (ICAM‐1) and lipoprotein were also detected .Results In ACS group ,53 cases were Cpn positive and 27 cases were Cpn negative ,and in control group ,7 cases were Cpn positive and 83 cases were Cpn negative ,which were with statistical difference between the two groups (P<0 .05) .Serum levels of TNF‐α,CRP ,ICAM‐1 ,total cholesterol ,triacylglycerol and low density lipo‐protein cholesterol were higher in chlamydia group and that of high density lipoprotein cholesterol was lower than non‐chlamydia group (P<0 .05) .Conclusion Chlamydia pneumoniae infection might be correlated with ACS .Chlamydia pneumoniae infection could be involved in disease development by increasing levels of inflammatory cytokines in ACS patients ,and further improve serum lipid levels .