集束化综合护理方案预防危重症患者肠内营养期间发生误吸的效果观察

The effect observation of bundles of combination nursing to prevent aspiration in critical patients during enteral nutrition period

目的探讨集束化综合护理方案对预防危重症患者肠内营养期间发生误吸的效果。方法选择2010年1月～2010年12月收住ICU的患者中进行肠内营养的834例患者为集束组,进行集束化综合护理方案:加强护理安全意识教育、意识状态的评估、注重喂养的体位与管道的位置、监测胃内残留量、注意输注速度与量、械通通气与其气囊的管理、加强口咽部护理。选择2009年1月～2009年12月收住ICU患者中进行肠内营养的756例患者为对照组,采用常规护理方案。比较2组患者肠内营养期间误吸的发生情况。结果集束组误吸的发生率较对照组明显下降(χ2=36.536,P<0.05),差异有统计学意义。结论集束化综合护理方案能减少危重症患者肠内营养期间误吸的发生率,值得临床推广使用。

Objective To explore the effect of bundles of combination nursing to prevent aspiration in critical patients during enteral nutrition period. Methods 1590 patients with enteral nutrition in ICU were divided into two groups. Patients of intervention group （834 patients） accepted bundles of combination nursing, including strengthening the nursing safety education, assessing the state of consciousness, focusing on the feeding position and the location, monitering gastric residual volume, paying attention on the rate and quantity of injection, and the air bollum of mechanical ventilation, strengthen the oropharynx nursing. Patients of control group （756 patients） accepted regular nursing plan. The aspiration incidences of two groups were compared. Results The aspiration incidences of intervention group significantly lower than the control group （P 〈 0.05 ）. Conclusion The bundles of combination nursing can reduce the aspiration incidence during enteral nutrition of the critical patients, which should be widely used in clinical nursing.