神经外科ICU患者胃内容物反流相关因素分析  

Correlative factors analysis of gastric content reflux in NICU

作　　者：王军[1] 郭桂丽[1] 鲍月红[1] 王艳玲[2] 肖倩[2] 吴瑛[2] 

机构地区：[1]首都医科大学宣武医院神经外科ICU,100053 [2]首都医科大学护理学院,100069

出　　处：《中华现代护理杂志》2015年第19期2264-2266,共3页Chinese Journal of Modern Nursing

基　　金：2012年度首都中医药与护理专项课题基金资助项目（10ZYH13）

摘　　要：目的：了解神经外科ICU患者胃内容物反流的发生情况,分析发生胃内容物反流的危险因素,为临床及时给予有效护理干预措施提供依据。方法选取某三级甲等医院神经外科 ICU病房47例机械通气患者进行病情观察,收集年龄、性别、体位、意识状态、胃潴留量、鼻饲管口径、人工气道气囊压力等数据,采集咽喉部分泌物进行胃蛋白酶检测及 pH测定。结果47例机械通气患者共观察235例次,胃内容物反流的发生率为48.1%。单因素分析显示,不同胃管直径型号、鼻饲液泵入速度、胃潴留量、Glasgow评分、气囊压力对胃内容物反流影响差异有统计学意义（χ^2值分别为6.641,56.615,142.846,17.784,8.620；P〈0.05）。进一步采用Logistic回归分析,胃内容物反流的影响因素为鼻饲液泵入速度、胃潴留量。结论胃内容物反流是神经外科ICU患者肠内营养时常见的并发症,根据胃内容物反流的发生原因,对于持续泵入鼻饲液的患者应注意监测胃内潴留量,采取合理的鼻饲液泵入速度,以降低胃内容物反流的发生率。Objective To investigate the gastric contents reflux occurred in the patients in Neurosurgery Intensive Care Unit （ NICU） , and to analyze the risk factors of gastric contents reflux and provide basis for timely and effective nursing intervention measures of clinical practice. Methods A total of 47 patients with mechanical ventilation in NICU of some grade A class three hospitals were collected the data such as age, gender, body posture, state of consciousness, gastric retention, diameter of nasogastric tube, the ballonet pressure of artifical airway and also included samples of throat secretion to test pepsin and pH. Results A total of 235 times watched among 47 patients that the incidence rate of gastric contents reflux was 48. 1%. The single factor analysis showed that there were significant differences of gastric contents reflux between subgroups of different tube diameter, nasal feeding pump rate, gastric retention, Glasgow score and ballonet pressure （χ2 =6. 641, 56. 615, 142. 846, 17. 784, 8. 620;P〈0. 05）. Further logistic regression analysis indicated that the factors affected gastric contents reflux was nasal feeding pumping rate and gastric retention. Conclusions Gastric contents reflux is a common complication in EN patients in the NICU. According to the Influencing factors, monitoring gastric retention and set proper nasal feeding pump rate is important for continuous nasal feeding patients to reduce gastric contents reflux rate.

关 键 词：重症监护病房 神经外科 胃内容物反流 影响因素 

分 类 号：R473.6[医药卫生—护理学]