生大黄在促进重症颅脑损伤患者胃肠道功能恢复中的疗效观察与护理

Effect of rhubarb in promoting the recovery of gastrointestinal function in patients with severe brain injury and nursing

目的探讨生大黄鼻饲促进重症颅脑损伤患者消化道功能恢复的疗效与护理。方法采用前瞻性随机对照研究方法，将80例重症颅脑损伤患者随机分成干预组（n=50）和对照组（n=30）。干预组予生大黄鼻饲，每天3次；对照组予鼻饲相同剂量的温开水；两组其他治疗措施相同。比较两组患者肠鸣音恢复时间、排气时间、排便时间、住院ICU时间和腹泻发生率。结果干预组肠鸣音恢复时间、肛门排气、排便时间、ICU住院天数分别为（35．08±6．22）h，（44．56±5．98）h，（53．74±5．23）h，（11．64±1．49）d，均优于对照组的（61．00±7．67）h，（72．60±5．21）h，（83．53±6．07）h，（21．87±1．73）d，差异均有统计学意义（t分别为-16．50，-21．27，-23．19，-27．86；P〈0．01）；腹泻发生率干预组为10．O％，对照组为6．6％，两组比较差异无统计学意义（χ2=0．27，P〉0．05）。结论应用生大黄鼻饲能够促进重症颅脑损伤患者胃肠道功能恢复，缩短ICU住院时间。

Objective To discuss the effect of rhubarb in promoting the recovery of gastrointestinal function in patients with severe brain injury and nursing. Methods prospective randomized controlled study was conducted. Totals of 80 patients with severe brain injuries were randomly divided into the intervention group （n =50） and the control group （n =30）. The intervention group was given 33mg/kg rhubarb by nasal feeding for three times a day, while the control group was given the same dose of warm water, and other treatment of both groups was the same. Bowel sound recovery time, evacuation time, defecating time, length of stay in ICU, and the incidence of diarrhea were observed and compared between two groups. Results Bowel sound recovery time, evacuation time, defecating time and length of stay in ICU were respectively（35.08 ±6.22）h, （44.56 ± 5.98 ） h, （ 53.74 ± 5.23 ） h, （ 11.64 ± 1.49 ） d in the intervention group, （ 61.00 ± 7.67 ） h, （ 72.60 ± 5.21 ） h, （83.53 ± 6.07 ）h, （21.87 ± 1.73 ）d in the control group, and the differences were statistically significant （t = - 16. 50, - 21.27, - 23.19, - 27.86, respectively;P 〈 0. 01 ）. The incidence of diarrhea was 10.0% in the intervention group and 6.6% in the control group, and there was no statistically significant difference （ χ2 = 0. 27,P 〉 0.05 ）. Conclusions Application of rhubarb by nasal feeding can promote gastrointestinal function recovery for patients with severe brain injury and shorten their stay in ICU.