床边胃镜引导下留置鼻肠管与鼻胃管在危重症患儿肠内营养支持中的应用效果比较  

Comparison of application effects of bedside gastroscopy-guided indwelling nasointestinal tube and nasogastric tube in enteral nutrition support for critically ill children

作　　者：焦会坊 高亮 王静 JIAO Huifang;GAO Liang;WANG Jing(Department of Pediatric Intensive Care of Women and Children’s Hospital of Zhumadian Central Hospital,Zhumadian 463000 Henan,China)

机构地区：[1]驻马店市中心医院妇女儿童医院儿童重症医学科,河南驻马店463000

出　　处：《中国民康医学》2023年第2期164-166,170,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较床边胃镜引导下留置鼻肠管与鼻胃管在危重症患儿肠内营养支持(EN)中的应用效果。方法:回顾性分析2017年12月至2020年12月该院收治的122例危重症患儿的临床资料,按EN方法不同将患儿分为鼻肠管组、鼻胃管组各61例。鼻胃管组予以传统鼻胃管行EN,鼻肠管组予以鼻肠管行EN,比较两组置管成功时间和一次性置管成功率、治疗前后营养指标[血清白蛋白(ALB)、视黄醛结合蛋白(RBP)、血红蛋白(Hb)]水平、肠黏膜屏障功能指标[血清D-乳酸、肠型脂肪酸结合蛋白(I-FABP)]水平、健康状况[急性生理学及慢性健康状况评分系统(APACHEⅡ)]评分和并发症发生率。结果:鼻肠管组置管成功时间短于鼻胃管组,一次性置管成功率高于鼻胃管组,差异均有统计学意义(P<0.05);治疗后,鼻肠管组血清ALB、RBP、Hb水平均高于鼻胃管组,血清D-乳酸、I-FABP水平及APACHEⅡ评分均低于鼻胃管组,差异均有统计学意义(P<0.05);鼻肠管组并发症发生率为4.52%(3/61),低于鼻胃管组的16.39%(10/61),差异有统计学意义(P<0.05)。结论:对危重症患儿采用床边胃镜引导下留置鼻肠管行EN治疗可缩短置管成功时间,提高置管成功率,改善患儿营养状况和肠黏膜屏障功能,降低并发症发生率,效果优于常规鼻胃管。Objective:To analyze effects of bedside gastroscopy-guided indwelling nasointestinal tube in enteral nutrition(EN)support for critically ill children and its influence on prognosis.Methods:122 critically ill children in this hospital from December 2017 to December 2020were selected and randomly divided into nasointestinal tube group and nasogastric tube group,61 cases in each group.The nasogastric tube group was given traditional nasogastric tube for EN,while the nasointestinal tube group was given nasogastric tube for EN.The nutritional index levels,the body weight,the intestinal mucosal barrier function,the health status,the prognosis score,the incidence of complications,the catheterization success time,and the success rate of one-time catheterization were compared between the two groups.Results:After the intervention,the levels of serum albumin(ALB),retinol binding protein(RBP)and hemoglobin(Hb)in the nasointestinal tube group were higher than those in the nasogastric tube group(P<0.05).After the intervention,the levels of plasma D-lactic acid and serum intestinal fatty acid binding protein(I-FABP)in the nasointestinal tube group were lower than those in the nasogastric tube group(P<0.05).After the intervention,the acute physiology and chronic health evaluation II(APACHE II)score of the nasointestinal tube group was lower than that of the nasogastric tube group(P<0.05).The incidence of complications in the nasointestinal tube group was lower than that in the nasogastric tube group(P<0.05).The catheterization success time in the nasointestinal tube group was shorter than that in the nasogastric tube group,and the success rate of one-time catheterization was higher than that in the nasogastric tube group(P<0.05).Conclusions:The bedside gastroscopy-guided indwelling nasointestinal tube in EN support for the critically ill children can shorten the catheterization time,improve the success rate of catheterization,improve the nutritional status and the intestinal mucosal barrier function,and reduce the incidence of c

关 键 词：危重症 儿童 鼻肠管 鼻胃管 肠内营养 床边胃镜 

分 类 号：R459.7[医药卫生—急诊医学]