幽门后喂养信息化预警系统在神经重症患者中的应用  

Application of information-based early warning system for post-pyloric enteral nutrition in patients with severe neurological diseases

作　　者：王德生[1] 景新华[2] 韩小云[2] 刘玲[1] 钱婷 冯毅 WANG Desheng;JING Xinhua;HAN Xiaoyun;LIU Ling;QIAN Ting;FENG Yi

机构地区：[1]常州市第一人民医院神经外科,213000 [2]常州市第一人民医院护理部,213000

出　　处：《中华急危重症护理杂志》2025年第4期475-479,共5页Chinese Journal of Emergency and Critical Care Nursing

基　　金：吴阶平医学基金会临床科研专项资助基金(320.6750.2022-02-36)。

摘　　要：目的建立幽门后喂养信息化预警系统并评价其在神经重症患者肠内营养实施中的成效。方法成立多学科团队,基于误吸风险评估及护理质量指标,构建幽门后喂养信息化预警系统,对误吸风险进行预警及幽门后喂养提醒;对比2022年6月—12月(对照组)与2023年2月—7月(试验组)的幽门后喂养相关指标的差异。结果实施幽门后喂养信息化预警系统后,吸入性肺炎发生率、鼻肠管置管延迟时间均显著低于对照组(P<0.05);试验组幽门后喂养率、鼻肠管及时置管率、误吸风险评估复评及时率均显著高于对照组(P<0.05);误吸风险评估初评及时率、早期肠内营养执行率均差异无统计学意义(P>0.05)。结论幽门后喂养信息化预警系统的建立与实施,有利于误吸风险患者尽早采用幽门后喂养,减少误吸及吸入性肺炎的发生,从而保障患者安全。Objective To establish an information-based early warning system for post-pyloric enteral nutrition and evaluate its effect on enteral nutrition in patients with severe neurological diseases.Methods A multidisciplinary team was established to build an information-based early warning system for post-pyloric enteral nutrition based on aspiration risk assessment and nursing quality indicators.The system was used to warn the risk of aspiration and to remind the post-pyloric enteral nutrition.The differences in indicators related to post-pyloric enteral nutrition were compared between control group(June to December 2022)and experimental group(February to July 2023).Results The incidence of aspiration pneumonia and the delay time of nasointestinal tube insertion were significantly lower than those in the control group after the implementation of the information-based early warning system(P<0.05).The rate of post-pyloric feeding,the rate of timely nasointestinal catheterization and the re-evaluation timeliness rate of aspiration risk assessment in the experimental group were significantly higher than those in the control group(P<0.05).There was no significant difference in the initial assessment timeliness rate of aspiration risk assessment and the implementation rate of early enteral nutrition(P>0.05).Conclusion The establishment and implementation of the information-based early warning system for post-pyloric enteral nutrition is conducive to the early adoption of post-pyloric enteral nutrition in high-risk patients with aspiration as soon as possible.It can reduce the incidence of aspiration and aspiration pneumonia and ensure the safety of patients.

关 键 词：误吸 质量指标 重症监护 危重症护理 

分 类 号：R473.74[医药卫生—护理学]