低温肠内营养液在预防重型颅脑损伤患者应激性溃疡中的效果研究  

Effect of lowering the temperature of enteral nutrition on prevention of stress ulcer in patients with severe eraniocerebral injury

作　　者：王建宁[1] 周松[1] 王婧[2] 查丽玲[1] 霍雪琴 曾颖[2] 

机构地区：[1]南昌大学第一附属医院护理部,330006 [2]南昌大学护理学院

出　　处：《中国实用护理杂志》2017年第30期2330-2333,共4页Chinese Journal of Practical Nursing

基　　金：江西省卫生计生委科技计划（20155163）

摘　　要：目的 探讨低温肠内营养液在预防重型颅脑损伤患者应激性溃疡中的有效性及安全性,为重型颅脑损伤患者选择合适的肠内营养温度提供参考依据.方法 选取2015年11月至2016年12月南昌大学第一附属医院神经外科监护室收治的84例行肠内营养的重型颅脑损伤患者,采用随机数字表法分为试验组和对照组,每组42例.试验组肠内营养温度设为22℃恒温,对照组为38℃恒温,观察比较2组患者肠内营养7 d内胃液pH值、胃液隐血试验及排便情况.结果 肠内营养第1、4、7天试验组患者胃液pH值分别为2.61 ± 0.37、4.55 ± 0.35、4.87 ± 0.34,均高于对照组的2.21 ± 0.44、3.93 ± 0.22、4.18 ± 0.30,差异有统计学意义（t=3.856、8.185、8.322,均P〈0.01）,2组患者胃液隐血试验阳性率差异无统计学意义（x2=0.102、0.408、1.332,均P〉0.05）;行肠内营养期间2组患者腹泻发生率及开始时间差异均无统计学意义（x2=0.288、t=0.372,均P〉0.05）.结论 低温肠内营养液对重型颅脑损伤患者胃黏膜具有一定的保护作用,有助于预防应激性溃疡,且不会增加腹泻的风险.Objective To probe into the efficacy and safety of lowering the temperatures of enteral nutrition in severe craniocerebral injury patients to prevent stress ulcer,and provide reference for patients with severe craniocerebral injury to choose appropriate enteral nutrition temperature. Methods The clinical randomized controlled trial was adopted.Numbered the patients by the order of being hospitalized, then divided the 84 patients with severe craniocerebral injury who were receiving enteral nutrition into experimental group and control group with 42 cases each.The constant temperature in experimental group was 22 ℃, and that in control group was 38 ℃. Observed and compared regularly the pH levels, occult blood test of gastric juice and defecate of the two groups within 7 days. Results After different temperature enteral nutrition,pH value of gastric juice of patients at 1,4,7 days after enteral nutrition was 2.610.37,4.550.35,4.870.34 in experimental group,2.210.44,3.930.22,4.180.30 in control group,there was significant difference between two groups （t=3.856, 8.185, 8.322, all P〈0.01）. There was no significant difference between two groups in the positive rate of gastric occult blood test（x2=0.102,0.408, 1.332, all P〉0.05）. There was no significant difference in the incidence of diarrhea and diarrhea start time between two groups （x2=0.288, t=0.372, all P〉0.05）. Conclusions Lowering the temperature of enteral nutrition has a certain protective effect on the gastric mucosa of patients with severe craniocerebral injury,which is helpful to prevent the occurrence of stress ulcer,and does not increase the risk of diarrhea.

关 键 词：温度 颅脑损伤 肠内营养 应激性溃疡 

分 类 号：R651.15[医药卫生—外科学]