两种不同鼻饲管行肠内营养发生并发症的比较及护理

目的探讨胃切除术后应用复尔凯鼻肠营养管及胃管进行肠内营养并发症的观察及护理要点。方法选择2007年1月-2009年12月本院63例胃切除术后应用肠内营养的患者,随机分为复尔凯鼻肠营养管组38例和普通胃管组25例。比较两组患者导管相关并发症(咽部不适、堵管、脱管)发生率。结果复尔凯鼻肠营养管咽部不适发生率低于胃管(P<0.001);复尔凯鼻肠营养管2例出现缝线断裂,用胶布固定的6例出现滑动,胃管7例出现滑动,两组用胶布固定的滑脱率比较,P>0.05,差异无统计学意义;两组患者堵管或不畅发生率比较,P>0.05,差异无统计学意义。结论胃切除术后肠内营养支持应用复尔凯鼻肠营养管与胃管是安全有效的。复尔凯鼻肠营养管咽部不适及滑动的发生率较低。

Objective To discuss the nursing points when caring for patients receiving enteral nutrition after gastrectomy and to handle with the tube-related complications.Methods Sixty-three gastrectomy patients receiving enteral nutrition （EN） were included.Thirty-eight patients used nasal-enteral tube while 25 patients used gastric tube.The incidence of tube related complications （pharyngeal discomfort,dislocation and blockage） were compared between the gastric tube group and the nasal-enteral tube group.Results Compared with gastric tube,nasal-enteral tube displayed a significantly lower incidence regarding pharyngeal discomfort（P 0.001）.Tube dislocation occurred in six patients in the nasal-enteral tube group and in seven patients in the gastric tube group.No significant difference was found in sutures fixation to prevent tube dislocation （P〈0.05）.No significant difference was found in blockage rate （P〈0.05）.Conclusions Both nasal-enteral tube feeding and gastric tube feeding in EN after gastrectomy were safe and efficient.When the nasal-enteral tube feeding is used,the incidence of pharyngeal discomfort is low,and when the gastric tube feeding is used,the blockage rate is low.During the implementation,an individualized option regarding tube types,placing and fixation was recommended and the blockage should be detected and handled promptly.