不同肠内营养对呼吸机相关性肺炎的作用分析

Analysis of different enteral nutrition to ventilator associated pneumonia

目的探讨鼻胃管和鼻肠管两种肠内营养对呼吸机相关性肺炎的作用分析,从而选择副作用较少的一种进行推广,以提高患者的预后及生活质量。方法选取ICU病房患者38例,并随机分为鼻胃管组与鼻肠管组,均为19例患者。两组均进行肠内营养插管,并给予相同的营养剂,观察患者在治疗前后的肠内营养变化、呼吸机相关性肺炎的发生率,两种肠内营养方式的不良反应比较,以及入住ICU病房时间和机械通气时间。结果进行两种肠内营养方式治疗后,患者肠内营养指数均有明显改善;呼吸机相关性肺炎发生率,鼻胃管组为63.16%,鼻肠管组为21.05%,差异有统计学意义(P<0.05);鼻胃管组不良反应产生较多,鼻肠管组不良反应产生较少,差异均有统计学意义(P<0.05);鼻胃管组ICU入住时间(12.1±1.8)d,机械通气时间(9.1±1.9)d,鼻肠管组ICU入住时间(7.8±1.2)d,机械通气时间和(5.3±1)d,差异有统计学意义(P<0.05)。结论行鼻肠管进行肠内营养对呼吸机相关性肺炎的发生率较鼻胃管低,相应的不良反应及入住ICU病房和机械通气的时间也较少,所以在机械通气时行鼻肠管进行肠内营养对呼吸机相关性肺炎的防治作用要优于鼻胃管进行肠内营养。

Objective To discuss the enteral nutrition of naso - gastric tube and naso-intestinal tube to ventilator associated pneu- monia. Methods 38 patients from ICU were randomly divided into two groups： the naso-gastric tube group and the naso-intestinal tube group. The following indexes were observed ： incidence of ventilator associated pneumonia, adverse reactions and ventilation time in ICU. Results The improvement of the above indexes was more pronounced in the the naso-intestinal tube group than in the naso-gastric tube group with statistical significance （ P 〈 0. 05 ）. Conclusion Naso-intestinal tube is more appropriate than naso-gastric tube to patients treated with mechanical ventilation, which is worth to be applied widely in clinical practice.