两种置管方式肠内营养治疗神经重症的临床疗效分析  

Clinical Effect Analysis of Two Tube Placement Methods for Enteral Nutrition in Treatment of Severe Neurological Disorders

作　　者：崔鹏 李瑞芳 赵萍 牟伟峰 CUI Peng;LI Ruifang;ZHAO Ping;MU Weifeng(Weifang City Fangzi District People's Hospital,Weifang,Shandong 261200)

机构地区：[1]潍坊市坊子区人民医院,山东潍坊261200

出　　处：《智慧健康》2024年第8期43-46,50,共5页Smart Healthcare

摘　　要：目的评估两种置管方式肠内营养(EN)应用在神经重症患者中的临床疗效。方法选取2021年1月—2022年12月行EN的86例神经重症患者为研究对象,采用随机数字表法划分对照组[纳入43例,采用鼻胃管肠内营养(NGEN)]、观察组[纳入43例,采用鼻空肠管肠内营养(NJEN)],评价组间营养指标、T细胞亚群、急性生理与慢性健康量表(APACHEⅡ)、格拉斯哥昏迷量表(GCS)、炎症因子、并发症。结果①置管前,组间营养指标、T细胞亚群、APACHEⅡ、GCS、炎症因子,对比差异无统计学意义(P>0.05);置管2周后,观察组营养指标、T细胞亚群、APACHEⅡ、GCS、炎症因子更佳,组间差异有统计学意义(P<0.05);②较之对照组,观察组返流、误吸、吸入性肺炎的发生率更低,组间差异有统计学意义(P<0.05),组间消化道出血、腹泻发生率无差异(P>0.05)。结论对神经重症患者实施NJEN,可以尽快改善营养及免疫状况,促进意识与病情恢复,控制炎症状态,减少返流、误吸等并发症,值得推广。Objective To evaluate clinical effect of two tube placement methods for enteral nutrition(EN)for critically ill patients with neurological disorders.Methods The paper chose 86 critically ill patients with neurological disorders with EN from January 2021 to December 2022 for study,and divided them into control group(43 cases,treated with nasogastric enteral nutrition(NGEN))and observation group(43 cases,with nasogastric enteral nutrition(NJEN))with random number table method.Nutritional indicators,T cell subsets,acute physiological and chronic health scale(APACHEⅡ),Glasgow coMA scale(GCS),inflammatory factors,and complications were evaluated between groups.Results①Before catheterization,there was no difference in nutritional indicators,T cell subsets,APACHEⅡ,GCS,and inflammatory factors between groups,with P>0.05.After 2 weeks of catheterization,observation group showed better nutritional indicators,T cell subsets,APACHEⅡ,GCS,and inflammatory factors,with P<0.05.②Incidence of reflux,aspiration,and aspiration pneumonia in observation group was lower than control group,P<0.05.There was no difference in incidence of gastrointestinal bleeding and diarrhea between groups,P>0.05.Conclusion NJEN can improve nutritional and immune status of critically ill patients as soon as possible,can promote awareness and recovery,control inflammation,and reduce complications including reflux and aspiration,which is worth promoting.

关 键 词：置管方式 肠内营养 神经重症 

分 类 号：R741[医药卫生—神经病学与精神病学]