留置胃管长度及鼻饲量对老年鼻饲患者食道反流发生的影响

目的探讨留置胃管长度及鼻饲量对老年鼻饲患者食道反流发生的影响。方法选择102例不能进食的留置胃管的老年患者随机分为实验组(A组)插入胃管长度55～65cm,对照组(B组)为45～55cm,两组患者鼻饲量,每次各为<200mL和200～300mL及300～400mL,分别为A1、A2和A3组,B1、B2和B3组。比较不同鼻饲量和留置胃管长度发生食道反流情况。结果实验组(A组)总的食道反流率为6.6%,对照组(B组)为11.6%,两组比较,χ2=160.07,P<0.05,差异具有统计学意义。插入胃管长度55～65cm鼻饲量<200mL(A1组)发生反流率最低,鼻饲量200～300mL次之(A2组),鼻饲量300～400mL(A3组)发生反流率最高,其均低于插管长度45～55cm组,组间比较,差异具有统计学意义(均P<0.05);其组内比较A1组与A2组,B1组与B2组反流率比较,差异无统计学意义(均P>0.05)。结论鼻饲置管长度为55～65cm,每次鼻饲量为200～300mL,既可满足不能进食的老年患者营养需求,又能达到降低食道反流发生的目的。

Objective To investigate the effect of a retained gastric tube at different lengths and the nasal feeding of different amounts on esophageal regurgitation in old patients. Methods 102 old patients with fasting to undergo retaining gastric tube were randomized into group A with inserting the gastric tube at a length of 55 - 65 em and group B at a length of 45 - 55 cm. Each group was divided into sub-groups A1, A2 and A3, and B1, B2 and B2 for the different amounts of nasal feeding of less than 200 mL, 200 - 300 mL and 300 - 400 mL, respectively. The comparisons were made between the groups in terms of esophageal regurgitation. Results The general rates of esophageal regurgitation of group A and group B were 6.6% and 11.6%, with significant differences （X2 = 160.07, P 〈 0.05）. In group A, group A1 （the amount of nasal feeding at an amount.of less than 200 mL） was lowest in the rate of esophageal regurgitation, followed then by group A2, and group A3 was the largest, but the rates in group A were significantly lower than those in group B, correspondingly （all P 〈 0.05）. Without each group, the differences between groups A1 and A2, groups B1 and B2 were insignificant, respectively （P 〉 0.05）. Conclusion Nasal feeding at an amount of 200 - 300 mL when the gastric tube is inserted at a length of 55 - 65 cm is good both for the nutrition intakes and for prevetion of esophageal regurgitation in old patients.