重型脑外伤昏迷气管切开术后鼻饲模式的探讨

Study on mode of nasal feeding in comatose patients with severe craniocerebral trauma after tracheotomy

目的探讨重型脑外伤昏迷气管切开术后长期鼻饲匀浆膳食的最佳鼻饲模式。方法重型脑外伤昏迷气管切开术的住院患者60例,随机分为实验组和对照组各30例,改进鼻饲模式每日鼻饲匀浆膳食4次,每次450ml,匀浆膳食间隔时间为5h;常规鼻饲模式每日鼻饲匀浆膳食6次,每次300ml,匀浆膳食间隔时间3h。两组患者均观察60d,实验组患者前30d按照改进鼻饲模式进行鼻饲,后30d按照常规鼻饲模式进鼻饲;对照组患者前30d按照鼻饲模式进行鼻饲,后30d按照鼻饲模式进行鼻饲。结果两组患者营养状况及鼻饲并发症相比较,差异均无显著性(P>0.05);与常规鼻饲模式比较改进鼻饲模式护士的鼻饲日工作时间明显减少(P<0.01),且患者在两次匀浆膳食之间的胃休息时间明显延长(P<0.01)。结论改进鼻饲模式对重型脑外伤昏迷气管切开术后病人的长期鼻饲匀浆膳食更适宜。

Objective To study the best mode of nasal feeding by tube in comatose patients with severe craniocerebral trauma after tracheotomy.MethodsSixty comatose patients with severe craniocerebral trauma after tracheotomy hospitalized in this hospital were randomly divided into trial group（n=30）and control group（n=30）.Patients in trial group were adopted with modified mode of nasal feeding.They received nasal feeding 4 times a day,450 ml per time,and the interval for each meal was 5 hours.Patients in control group were adopted with common mode of nasal feeding.They received nasal feeding 6 times a day,300 ml per time,and the interval for each meal was 3 hours.The patients in trial group were adopted with modified mode for 30 days,and then they were applied with common mode for the next 30 days.It was reversed in patients of control group.Results There was no significant difference in nutritional status and complications among patients in these two groups（P〉0.05）.In comparison with that of control group,the daily working time of nurses for nasal feeding in trial group was significantly reduced（P〈0.01）,and the rest time for stomach between two meals could be prolonged（P〈0.01）.Conclusion The modified mode for nasal feeding is more suitable for aged patients with severe craniocerebral trauma for receiving longer period of paste-formulated diet.