机械通气病人鼻胃管对胃液返流和误吸的影响

Effect study on regurgitation and pulmonary miss-inhalation for mechanically ventilated patients

目的探讨鼻胃管是否增加机械通气病人胃内容物的返流和误吸。方法采用随机自身前后对照试验 ,对机械通气可望 >96h的 2 6例患者在带或不带胃管时胃食管返流和误吸情况进行研究。结果鼻胃管存在时返流次数 (88.3%VS77.3% ,P =0 .0 34)和吸入次数 (2 7.5 %VS2 1 .8% ,P =0 .31 9)比没有鼻胃管时高 ;口咽部分泌物 (5 2 86± 2 5 35VS 35 75± 2 1 91 ,P =0 .0 2 2 )和支气管吸出物 (5 36± 2 73VS 4 32± 2 5 8,P =0 .1 6 9)的放射水平也较没有鼻胃管时高。

Objective To determine if nasogastric tube increases gastroesophageal regurgitation and pulmonary miss inhalation of gastric contents for mechanically ventilated patients. Methods A randomized crossover trial was employed to study 26 patients expected to receive mechanical ventilation more than 96hrs in the presence of nasogastric tube and in the absence of nasogastric tube on the second and fourth day after initiation of mechanical ventilation. Results Patients had more episodes of gastroesophageal regurgitation (88.3% vs 77.3%, P =0.034 ) and tended to more aspiration (27.5%vs21.8%, P =0.319) while they were in the presence of nasogastric tube than that they were in the absence of nasogastric tube. Mean radioactive counts in oropharyngeal (5 286±2 535 vs 575±2 191, P =0.022), and bronchial (536±273 vs 432±258, P =0.169 ) secretions were higher while patients were in the presence of nasogasstric tube than that they were in the absence of nasogastric tube . Conclusion The presence of nasogastric tube is a potential risk factor for gastroesophageal reflux of gastric contents .