空肠管在颅脑损伤患者的临床应用及感染预防  

Clinical application of jejunum tube in enteral nutrition support of craniocerebral injury patients and infection prevention

作　　者：魏君[1] 宋鑫[1] 廖珩[1] 

机构地区：[1]唐山市工人医院神经外科,河北唐山063000

出　　处：《中华医院感染学杂志》2014年第1期176-178,共3页Chinese Journal of Nosocomiology

基　　金：唐山市科技支撑计划基金项目(121302766)

摘　　要：目的研究漂浮法空肠管在颅脑损伤患者肠内营养支持中的临床应用效果及感染预防措施,以期提高颅脑损伤患者的临床治疗质量。方法将2010年1月-2013年1月入院进行肠内营养支持的颅脑损伤患者210例,随机分为试验组和对照组,各105例,试验组应用鼻空肠管,对照组应用鼻胃管,观察两组患者肠内营养支持及并发症状况,并分析预防感染的办法。结果置管10d后,试验组格拉斯哥昏迷评分(GCS)为(6.7±1.3)分,对照组为(5.4±1.0)分;置管前与置管2d后两组患者在血清总蛋白(TP)、前白蛋白(PA)、血红蛋白(Hb)差异无统计学意义,在置管7、10d发现,两组患者在TP、PA、Hb差异有统计学意义(P<0.05),试验组营养支持更好;试验组误吸7例、反流10例、腹胀4例、消化道出血7例、感染2例;对照组误吸18例、反流35例、腹胀12例、消化道出血10例、感染4例,除腹泻外,其他并发症差异均有统计学意义(P<0.05)。结论空肠管对颅脑损伤患者营养支持作用较好,且并发症较少;加强导管护理、密切观察、严格无菌操作是预防感染的重要举措。OBJECTIVE To study the effect of clinical application of floating jejunum tube on enteral nutrition support of the patients with craniocerebral injury and put forward infection prevention measures so as to improve the quality of clinical treatment of craniocerebral injury.METHODS A total of 210cases of craniocerebral injury,who underwent the enteral nutrition support in the hospital from Jan 2010 to Jan 2013,were enrolled in the study and randomly divided into the experimental group and the control group,with 105cases in each,the experimental group was treated with nasal jejunum tube,while the control group was treated with the nasogastric tube,then the enteral nutrition support and the incidence of complications were observed and compared between the two groups, and the infection prevention measures were put forward.RESULTS Ten days after the catheterization,the Glasgow Coma Scale（GCS）score was（6.7±1.3）points in the experimental group,（5.4±1.0）points in the control group.The difference in the serum total protein（TP）,prealbumin（PA）,or hemoglobin（Hb）before the catheterization or 2days after the catheterization between the two groups was not significant;while the difference in the TP,PA,or Hb at 7 or 10days after the catheterization between the two groups was significant（P0.05）.The enteral nutrition support of the experimental group was better.There were 7 cases of aspiration in the experimental group,18cases in the control group;there were 10cases of reflux in the experimental group,35cases in the control group;there were 4 cases of abdominal distension in the experimental group,12cases in the control group; there were 7cases of gastrointestinal bleeding in the experimental group,10 cases in the control group;there were 2cases of infections in the experimental group,4cases in the control group;the difference in the incidence of all the complications was significant except for diarrhea（P0.05）.CONCLUSIONThe jejunum tube can achieve better effect on the enteral nutrition support of t

关 键 词：空肠管 鼻胃管 颅脑损伤 肠内营养 感染预防 

分 类 号：R181.32[医药卫生—流行病学]