神经内科危重病人肠内营养不同输注速度对胃潴留的影响  

Effects of pumping speeds of enteral nutrition on gastric retention in NICU patients

作　　者：卢丽华[1] 蔡博瑜 朱小玲[1] LU Li-hua;CAI Bo-yu;ZHU Xiao-ling(Neurology department,Affiliated Hospital of Nantong University,Nantong 226000,Jiangsu,China)

机构地区：[1]南通大学附属医院神经内科,江苏南通226000

出　　处：《肠外与肠内营养》2020年第6期368-371,共4页Parenteral & Enteral Nutrition

基　　金：南通大学附属医院科技项目(Tfh1801)。

摘　　要：目的:探讨肠内营养(EN)液不同输注速度对神经内科危重病人胃潴留的影响。方法:将109例进行EN的病人根据洼田饮水试验不同结果将其分为A、B、C三组,洼田饮水试验5分为A组,4分为B组,3分为C组。A组EN输注速度为60~79 m L/h;B组80~99 m L/h;C组100~120 mL/h,温度控制在39℃~41℃,观察各组病人住院期间胃潴留的发生情况。结果:同A组病人相比,B组病人发生胃潴留的风险并未显著增加(OR=2.062,95%CI:0.477~8.919,P=0.333),C组病人发生胃潴留的风险显著增加(OR=5.315,95%CI:1.198~23.574,P=0.028),线性趋势检验显示,输注速度与胃潴留风险之间存在显著性的剂量反应关系(线性趋势P<0.05)。结论:使用加温营养泵,温度控制在39℃~41℃,输注速度在60~100 mL/h时可有效减少胃潴留的发生,考虑到鼻饲时间和临床护理人员的工作量等客观因素,神经内科危重病人在入院第4天,泵入速度80~100 mL/h值得在临床推广应用。Objective:To investigate the influence of different pumping speeds of enteral nutrition on gastric retention in critically ill patients hospitalized in the Department of Neurology.Methods:A total of 109 patients who were received enteral nutrition administration were randomly divided into three groups:A,B and C.The enteral nutritional suspensions were pumped at the speeds of 60~79 mL/h for group A,80~99 mL/h for group B and 100~120 mL/h for group C,respectively.The temperatures of the suspensions were controlled at 39℃~41℃.The presence of gastric retention during hospitalization was observed in the patients.Result:Compared to group A,the risk of gastric retention was significantly increased in group C(OR:5.315,95%CI:1.198~23.574).However,no significant difference in the risk of gastric retention was observed between groups A and B(OR:2.062,95%CI:0.477~8.919).Linear trend test showed that the prevalence of gastric retention in the patients was elevated with the increase of the pumping speed(P<0.05).Conclusion:We demonstrated that the suitable control of the pumping speeds(60~100 mL/h)and suspension temperatures(39℃~41℃)could reduce the presence of gastric retention.Considering the multiple factors,such as nasal feeding time and nurse’s workload,the pumping speeds of 80~100 mL/h should be recommended for application in clinical practice.

关 键 词：危重病人 肠内营养液 速度 胃潴留 

分 类 号：R459.3[医药卫生—治疗学]