肠内营养期间胃窦横截面积变化轨迹对脓毒症患者喂养不耐受的预测效能OA

Objective To investigate the predictive efficacy of the gastric antral cross-sectional area(CSA)trajectories during enteral nutrition for feeding intolerance in patients with sepsis.Methods A total of 110 patients with sepsis who were admitted to Xingtai Central Hospital from August 2024 to April 2025 and were scheduled to receive enteral nutrition intervention were consecutively included.Bedside ultrasound was used to measure CSA on the 1st,2nd,and 3rd days of enteral nutrition intervention.The latent class trajectory model(LCTM)was used to screen the trajectories of CSA,and the occurrence of feeding intolerance during enteral nutrition intervention was statistically analyzed.Logistic regression analysis was used to analyze the impact of CSA trajectories on feeding intolerance,and the receiver operating characteristic(ROC)curve was used to analyze the predictive value of CSA trajectories.Results During the 1st,2nd,and 3rd days of enteral nutrition intervention,the CSA of 110 patients with sepsis was(185.32±28.94),(133.76±32.00),and(94.57±28.19)cm2 respectively,showing a continuous decreasing trend(P<0.01).LCTM analysis revealed that retaining three potential categories was the optimal model.Based on the established optimal model,the trajectories of CSA in sepsis patients undergoing enteral nutrition intervention were divided into three groups:T1 group(n=40,rapidly decreasing from a low level),T2 group(n=39,rapidly decreasing from a medium-low level),and T3 group(n=31,slowly decreasing from a high level).There was 1 case of feeding intolerance in the T1 group(2.50%),9 cases in the T2 group(23.08%),and 26 cases in the T3 group(83.87%).The feeding intolerance rate in the T2 and T3 groups was higher than that in the T1 group(P<0.01).After correcting the related indicators,with the T1 group as the reference,the risk of feeding intolerance in the T2 group and T3 group increased by 1.957 times and 3.390 times respectively.When the trajectory of CSA was characterized by a slow decline from a high level,the area under the ROC curve for predicting feeding intolerance was 0.827,with a sensitivity of 72.22%,and a specificity of 93.24%.Conclusion The trajectory of CSA during enteral nutrition is related to the risk of feeding intolerance in septic patients.When the trajectory of CSA is characterized by a slow decline from a high level,it has predictive value for feeding intolerance,which is helpful for improving risk stratification management and enhancing the safety and effectiveness of enteral nutrition support.