鼻肠管预防重型颅脑损伤行气管切开患者肠内营养时误吸的效果  

Effect of Nasointestinal Tube in the Prevention of Enteral Nutrition Aspiration of Patients with Severe Craniocerebral Injury Undergoing Tracheotomy

作　　者：高君梅 井文婷 吴玉燕[1] 

机构地区：[1]第四军医大学唐都医院神经外科监护室,陕西西安710038

出　　处：《解放军护理杂志》2015年第17期49-50,52,共3页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的探讨鼻肠管在重型颅脑损伤行气管切开实施肠内营养(enteral nutrition,EN)治疗患者中预防误吸的效果。方法采用便利抽样法选择某医院神经外科重型颅脑损伤行气管切开患者65例,按随机数字表法分为对照组32例(鼻胃管组)、观察组33例(鼻空肠管组),观察组通过床旁盲插鼻肠管实施EN,对照组通过普通胃管实施EN,均给予EN护理常规护理。检测治疗前和治疗后2、3、4周血清白蛋白、转铁蛋白、前白蛋白水平,并监测患者各项胃肠道功能障碍(包括胃潴留、误吸、腹泻)指标、吸入性肺炎发生率和达到全量营养的时间。结果两组患者各阶段血清白蛋白、转铁蛋白、前白蛋白及达到全量营养时间的比较,差异均无统计学意义(均P>0.05);观察组患者胃肠功能障碍及吸入性肺炎的发生率低于对照组,差异有统计学意义(P<0.05)。结论盲插鼻肠管的应用可以提高患者对肠内营养的耐受性,减少误吸及吸入性肺炎的发生率,值得临床推广应用。Objective To discuss the effect of nasointestinal tube in the prevention of enteral nutrition（EN）aspiration of patients with severe craniocerebral injury undergoing tracheotomy.Methods Totally 65 severe craniocerebral injury patients were randomly divided into control group（n=32）（nasogastric tube group）and observation group（n=33）（nasal jejunal tube group）.The patients in the observation group were treated with implementation of EN through blind nasal bowel loops,while the control group received a daily routine method,and all groups were treated with routine nursing care.The serum albumin,transferrin and prealbumin levels before treatment and 2,3,4weeks after treatment were compared,and monitor gastrointestinal function（including gastric retention,aspiration and diarrhea）and incidence rate of aspiration pneumonia and time to reach the full nutrition.Results There were no statistical significances of serum albumin,transferrin and prealbumin levels and time to reach full nutrition between two groups（all P〈0.05）.The gastrointestinal dysfunction and the incidences of aspiration pneumonia in observation group were lower than which in control group（P〈0.05）.Conclusion The application of blind plug nasal bowel loops can improve the tolerance of enteral nutrition,and reduces the aspiration and the occurrence of aspiration pneumonia,which is worthwhile for clinical application.

关 键 词：重型颅脑损伤 气管切开 肠内营养 盲插鼻肠管 误吸 

分 类 号：R651.15[医药卫生—外科学]