危重患者不同肠内营养置管支持的对比研究

Comparison Research of Different Placing Tube of Enteral Nutrition in Critical Patients

目的探讨危重患者经鼻空肠置管行肠内营养的应用价值。方法 ICU 50例机械通气患者随机分为A组(25例)和B组(25例),A组留置鼻空肠管,B组留置鼻胃管,观察两组患者耐受肠内营养的起始时间、达目标喂养量所需时间、机械通气时间、治疗1周后营养指标变化情况及并发症情况。结果 A组肠内营养可以耐受起始时间、达目标喂养量所需时间和机械通气时间均明显比B组短(P<0.05),胃潴留、呕吐误吸、呼吸机相关性肺炎(VAP)的发生率也明显比B组少(P<0.05),腹泻及治疗后营养指标变化情况与B组差异无统计学意义(P>0.05)。结论危重患者留置鼻空肠管实施早期肠内营养更为有效、安全,并发症少,住院费用减少,是一种值得提倡的置管方式。

Objective To explore the application of enteral nutrition by Nasal-jejunum tube in critical patients. Methods The fifty patients in ICU were randomly divided into group A and group B, Group A （Twenty-five patients） was supported through Nasal-jejunum tube and group B （Twenty-five patients） through nasal-gastric tube. The beginning time of enteral nutrition, the time of target volume, the mechanical ventilated time, the changes of nutritional index after one week nutrition supporting and the complication were observed. Results Compared with group B, the beginning time of enteral nutrition, the time of target volume and the mechanical ventilation time of group A were shorter significantly （ P 〈 0.05 ）, the occurrence rate of gastric retention, vomiting and aspiration,ventilator-associated pneumonia（VAP） in group A were decreased more signifieantly（P 〈0.05 ） ,but the diarrhea and the changes of nutritional index after treatment in group A and B there were no significant difference （ P 〉 0.05 ）. Conclusion Early enteral nutrition by Nasal-jejunum tube in critical patients was more effective and safe, with less complica- tions and hospitalization costs, it was worth advocating.