摘要
目的评价经鼻肠管置管行肠内营养减少食管反流和误吸,降低呼吸机相关性肺炎(VAP)的发生率。方法选取2012年1-12月入住ICU符合研究纳入标准的机械通气患者60例,按随机数字表随机分为两组进行肠内营养支持,试验组30例行鼻肠管喂养,对照组30例行鼻胃管喂养,两组均采取营养液持续均速泵入及实施呼吸机集束干预策略,比较两组胃肠道并发症和VAP发生率,对治疗前后患者体温、血白细胞(WBC)、血清降钙素原(PCT)水平进行检测记录。结果试验组VAP发生率16.7%均低于对照组46.7%,两组差异有统计学意义(P<0.05);试验组体温、WBC、血清PCT水平等均明显优于对照组,差异有统计学意义(P<0.05)。结论经鼻肠管行肠内营养可以增加肠内营养耐受性,提高营养指标水平,减少食管反流和误吸等常见肠内营养并发症的发生率,降低VAP的发生率,同时减少了机械通气时间和ICU住院率。
OBJECTIVE To evaluate the effects of enteral nutrition by nasointestinal tube on reducing esophageal reflux and aspiration and incidence of ventilator-associated pneumonia. METHODS A total of 60 patients with mechanical Ventilations were chosen and randomly divided into 2 groups with 30 cases in each. The experiment group was given nasointestinal tube feeding while the control group was given nasogastric tube feeding. Both groups were given nutrient solution pumping at sustained average rate and the ventilator bundle intervention strategies. Gastrointestinal complications and VAP occurrence rates of the 2 groups were compared. Body temperature, WBC and serum PCT levels of the patients before and after treatments were tested and recorded. RESULTS The VAP occurrence rate was 16.7% in the experiment group, significantly lower than 46.7% in the control group （P〈0.05）. Temperature, WBC and serum PCT levels in the experiment group were significantly better than the control group （P^0. 05）. CONCLUSION Enteral nutrition by nasointestinal tube can increase enteral nutrition tolerance, improve nutrition indicator level, reduce occurrence rate of common enteral nutrition complications such as esophageal reflux and aspiration, lower VAP occurrence rate, and meanwhile decrease mechanical ventilation time and ICU hospitalization rate.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第3期615-617,共3页
Chinese Journal of Nosocomiology
基金
浙江省护理学会科学基金资助项目(2011B12)
