80岁以上鼻饲患者餐后血压的变化

Clinical observation of postprandial blood pressure changes in the very elderly with nasal feeding

目的观察两种鼻饲方案的80岁以上患者餐后血压的变化，探讨减少餐后低血压（PPH）发生的方法。方法49例进行胃肠营养的老年患者随机分为持续鼻饲、间歇鼻饲两组，观察进餐前后血压、心率的变化及临床症状。结果间歇鼻饲组PPH发生率100．0％（26例），持续鼻饲组为47．8％（11例），差异有统计学意义（P〈0．01）；间歇鼻饲组餐后收缩压、舒张压较持续鼻饲组下降（P〈0．05），餐后心率较持续鼻饲组加快（P〈0．05）；间歇鼻饲组严重心脑缺血事件发生率为7．7％（2例），持续鼻饲组未出现严重心脑缺血事件。结论进行胃肠营养的80岁以上患者，持续鼻饲较间歇鼻饲降低PPH的发生率，可避免严重心脑血管事件的发生。

Objective To observe the changes of postprandial blood pressure and heart rate with two types of nasal feeding in the very elderly and explore the method for decreasing the postprandial hypotension （PPH）. Methods Totally 49 patients （aged〉80 years） were randomly divided into two groups of continuous versus intermittent nasal feeding. The clinical symptoms and changes in blood pressure and heart rate before and after meals were observed. Results The incidence of PPH was 100.0 % （26 cases）in the group of intermittent nasal feeding, and 47.8%（11 cases） in the group of continuous nasal feeding （P〈0.01）. Postprandial blood pressure in the group of intermittent nasal feeding was decreased significantly as compared with the group of continuous nasal feeding （P 〈0.05）; and the heart rate was accelerated in the group of intermittent nasal feeding compared with continuous nasal feeding （P〈0.05）. The incidence of serious cardio-cerebral ischemia was 7.7 % （2 cases）in the group of intermittent nasal feeding. The patients had no clinical symptoms in the group of continuous nasal feeding. Conclusions Continuous nasal feeding for the very elderly with gastrointestinal nutrition can reduce the extent of the falling blood pressure and the incidence of PPH, and avoide cardiocerebrovascular events.