两种鼻饲方案在危重患者肠内营养中的应用比较

Comparison of Two Methods of Nasogastric Feeding for Critical Patients' Enteral Nutrition

目的比较两种鼻饲方案对重症患者肠内营养的影响,为临床选择肠内营养方案提供依据。方法选择重症监护病房医嘱经鼻胃管采用鼻饲泵进行肠内营养的患者53例,对每例患者实施1周的持续鼻饲后改1周的间歇鼻饲,记录两个阶段患者腹胀、腹泻、误吸、反流等并发症的发生次数以及胃液pH值。结果两种鼻饲方案在腹胀、腹泻、误吸、反流等并发症的发生率差异无统计学意义(P>0.05),两种方案患者胃液平均pH值差异有统计学意义(P<0.05),间歇鼻饲方案时患者胃液pH值更接近生理值。结论应用鼻饲泵间歇鼻饲不会增加患者并发症的发生率,且对患者胃液pH值的影响程度小于持续鼻饲方案。

Objective To compare the effect of two methods of nasogastric feeding for critical patients＇ enteral nutrition and to provide the basis for the choice between them. Methods 53 patients were chosen who were supported by nasogastric feeding through pump from ICU. After one-week continuous nasogastric feeding, we changed the method to intermittent nasogastric feeding. Both methods lasted for one week. During two stages we recorded the incidence of complications such as abdominal distension, diarrhea, aspiration, reflux and the values of average pH of the gastric juice. Results The differences between the two methods in the incidence rate of abdominal distension, diarrhea, aspiration, reflux were not statistically significant （P〉0.05）, while the values of average pH of the gastric juice of the two groups was （P〈0.05）. Conclusion Compared with continuous nasogastric feeding, intermittent nasogastric feeding will not increase complication and has less effect on pH of gastric juice.