危重患者床旁留置鼻空肠营养管效果评价
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摘要
目的观察床旁安置空肠营养管在危重症患者肠内营养治疗的临床疗效。方法对31例危重症患者行鼻胃管营养(鼻胃管组),对59例危重症患者床旁留置鼻空肠管营养(鼻空肠管组)。结果两组置管成功率、置管时间比较,差异无统计学意义(均P>0.05),干预后两组APACHEⅡ评分、营养指标和腹胀、反流发生率比较,差异有统计学意义(P<0.05,P<0.01)。结论重症患者床旁留置鼻空肠营养管给予营养支持可显著改善患者的营养状况,且并发症发生率低,有助于稳定患者病情,改善预后。
Objective To observe the clinical effect of bedside placement of jejunum feeding tube in critical patients.Methods Totally31 critical patients were treated with nasogastric nutrition(the nasogastric tube group),and another 59 critical patients received bedside placement of nasal jejunal nutrition(the nasal jejunum tube group).Results There were no significant differences in the success rate of tube placement and indwelling catheter time between the two groups(P>0.05 for both).While after the intervention,there were significant differences in the APACHE II scores,nutrition indicators,and the incidence of abdominal bloating and reflux between the two groups(P<0.05,P<0.01).Conclusion Nutritional support by bedside placement of jejunum feeding tube through nose for critical patients can significantly improve patients′nutritional status,and reduce the incidence of complications,then stabilize their disease condition and improve the prognosis.
Objective To observe the clinical effect of bedside placement of jejunum feeding tube in critical patients.Methods Totally31 critical patients were treated with nasogastric nutrition(the nasogastric tube group),and another 59 critical patients received bedside placement of nasal jejunal nutrition(the nasal jejunum tube group).Results There were no significant differences in the success rate of tube placement and indwelling catheter time between the two groups(P>0.05 for both).While after the intervention,there were significant differences in the APACHE II scores,nutrition indicators,and the incidence of abdominal bloating and reflux between the two groups(P<0.05,P<0.01).Conclusion Nutritional support by bedside placement of jejunum feeding tube through nose for critical patients can significantly improve patients′nutritional status,and reduce the incidence of complications,then stabilize their disease condition and improve the prognosis.
引文
[1]郑祥德,冯清,周文来,等.床旁空肠营养管徒手置入技术在危重症病人营养治疗中的应用研究[J].肠外与肠内营养,2016,23(1):41-43.
[2]郑祥德,周文来,兰清.空肠营养管床旁徒手安置技术在基层医院重症监护病房的应用[J].中华临床营养杂志,2016,24(1):45-46.
[3]Sun X,Zhang H,Sheikhahmadi A,et al.Effects of heat stress on the gene expression of nutrient transporters in the jejunum of broiler chickens(Gallus gallus domesticus)[J].Int J Biometeorol,2015,59(2):127-135.
[4]朱丽萍,张占香.两种鼻空肠营养管置管方法在急性重症胰腺炎肠内营养中的应用[J].山西医药杂志,2016,45(16):1962-1963.
[5]蔡媛媛.急性重症胰腺炎患者应用鼻空肠营养管的护理体会[J].中国中医药咨讯,2012,4(3):350-350.
[6]景新华,徐静娟,王德生,等.重型颅脑损伤肠内营养患者双导丝鼻胃管置入空肠方法的改进[J].护理学杂志,2017,32(4):12-14.
[7]陈建军,姚洁,何磊,等.床旁盲插空肠营养管在重症监护病房患者中的应用研究[J].重庆医学,2013,42(30):3672-3674.
[8]谢艳梅,幸莉萍,梁玮秦.改良盲插法鼻空肠管置入术在危重症病人中的应用[J].肠外与肠内营养,2014,21(6):379.
[9]赵越,钟萍,贾承玲.追踪方法学用于老年患者经鼻空肠营养支持护理流程优化的实践[J].护理学杂志,2017,32(18):73-79.
[10]兰清,刘成,郑祥德.徒手盲视鼻空肠营养管置管法在危重症患者中的应用[J].现代医药卫生,2016,32(21):3295-3297.
[11]陈瑶.空肠营养管在重症患者中的应用[J].航空航天医学杂志,2012,23(3):346-347.
[12]冯源,吴楠,陈晋峰,等.术中经皮穿刺空肠营养管或经鼻空肠营养管置入对食管癌患者围手术期营养支持的影响[J].中华临床营养杂志,2013,21(1):8-12.
[13]聂川,李政文,何俊堂,等.重型颅脑损伤患者床旁经鼻胃镜直视下放置空肠营养管的临床应用[J].实用医学杂志,2013,29(2):334-335.
[14]冯丽娟,张军.巧用黄斑马亲水导丝辅助胃镜下放置鼻空肠营养管的护理配合[J].浙江临床医学,2017,8(12):2345-2345.
[2]郑祥德,周文来,兰清.空肠营养管床旁徒手安置技术在基层医院重症监护病房的应用[J].中华临床营养杂志,2016,24(1):45-46.
[3]Sun X,Zhang H,Sheikhahmadi A,et al.Effects of heat stress on the gene expression of nutrient transporters in the jejunum of broiler chickens(Gallus gallus domesticus)[J].Int J Biometeorol,2015,59(2):127-135.
[4]朱丽萍,张占香.两种鼻空肠营养管置管方法在急性重症胰腺炎肠内营养中的应用[J].山西医药杂志,2016,45(16):1962-1963.
[5]蔡媛媛.急性重症胰腺炎患者应用鼻空肠营养管的护理体会[J].中国中医药咨讯,2012,4(3):350-350.
[6]景新华,徐静娟,王德生,等.重型颅脑损伤肠内营养患者双导丝鼻胃管置入空肠方法的改进[J].护理学杂志,2017,32(4):12-14.
[7]陈建军,姚洁,何磊,等.床旁盲插空肠营养管在重症监护病房患者中的应用研究[J].重庆医学,2013,42(30):3672-3674.
[8]谢艳梅,幸莉萍,梁玮秦.改良盲插法鼻空肠管置入术在危重症病人中的应用[J].肠外与肠内营养,2014,21(6):379.
[9]赵越,钟萍,贾承玲.追踪方法学用于老年患者经鼻空肠营养支持护理流程优化的实践[J].护理学杂志,2017,32(18):73-79.
[10]兰清,刘成,郑祥德.徒手盲视鼻空肠营养管置管法在危重症患者中的应用[J].现代医药卫生,2016,32(21):3295-3297.
[11]陈瑶.空肠营养管在重症患者中的应用[J].航空航天医学杂志,2012,23(3):346-347.
[12]冯源,吴楠,陈晋峰,等.术中经皮穿刺空肠营养管或经鼻空肠营养管置入对食管癌患者围手术期营养支持的影响[J].中华临床营养杂志,2013,21(1):8-12.
[13]聂川,李政文,何俊堂,等.重型颅脑损伤患者床旁经鼻胃镜直视下放置空肠营养管的临床应用[J].实用医学杂志,2013,29(2):334-335.
[14]冯丽娟,张军.巧用黄斑马亲水导丝辅助胃镜下放置鼻空肠营养管的护理配合[J].浙江临床医学,2017,8(12):2345-2345.