老年鼻饲患者发生反流误吸原因及护理对策

Mistake Inhalation Causes and Nursing of Aged Patients with Nasal

目的：探讨老年病人鼻饲发生反流及误吸的原因和护理对策.方法：对我科2012年1月~2012年10月收治40例昏迷鼻饲病人的临床资料进行分析,找出鼻饲过程中发生反流误吸的相关因素.结果：40例老年鼻饲病人中发生明显反流6例,可疑反流2例,其中误吸2例中有1例出现急性呼吸衰竭.反流及误吸的发生与病人体位、胃管插入深度及粗细、鼻饲方式、腹胀胃潴留及吸痰刺激等有关.结论：老年病人鼻饲过程中反流、误吸的发生率高,可导致严重呼吸系统并发症,明显增加病人死亡率及致残率,护理过程中采取有效护理措施是可以预防的.

OBJECTIVE： To investigate the causes and nursing methods of the incidence of elderly patients with nasogastric re- flux. METHOD： The clinical data of 40 cases of coma patients with reflux in our department from January to October 2012 were analy- sised in order to find the cause of misaspiration during feading procers. RESULTS： Obvious reflux was occurred in 6 cases, suspi- cious reflux in 2 cases, misaspiration in 2 cases and one of them occured acute respiratory failure. The reflux and misaspiration were related to the patient＇ s position, depth and thickness, tube feeding methods, abdominal distension and gastric retention and aspira- tion of sputum stimulation. CONCLUSIONS： The rate of reflux and misaspiration occured in the elderly patients is high, which can lead to severe respiratory complications and increase patients＇ morbidity and mortality. And those can be prevented by taking effective nursing measures.