机械通气患儿肠内营养误吸现状及影响因素调查

Status and influencing factors of aspiration among mechanical ventilated children with enteral nutrition

目的探讨机械通气患儿肠内营养误吸的发生率及影响因素,为临床采取有效措施预防误吸发生提供依据。方法选取儿童重症监护病房机械通气患儿60例进行病情观察,收集年龄、性别、体位、意识、喂养因素、治疗因素等资料,采集气管分泌物,进行胃蛋白酶检测。结果共采集60例患儿312例次支气管分泌物标本,其中发生误吸27例(占45.00%)。性别、采集时间、胃残留量、插管方式及插管深度是机械通气患儿肠内营养误吸发生的影响因素。结论机械通气患儿肠内营养时误吸发生率高,应特别注意患儿夜间误吸发生情况,检测气管插管深度及胃残留量,以降低误吸发生率。

Objective To explore the incidence of aspiration and influencing factors among mechanical ventilated children with enteral nutrition, so as to provide basis for aspiration prevention. Methods A total of 60 mechanical ventilated children with enteral nutrition in pediatric intensive care unit were recruited, data such as age, gentler, position, consciousness, feeding factors, treating factors were collected, and tracheal secretions were collected for pepsin testing. Results Totally,312 times of tracheal secretion specimen of 60 children were collected, among these,27 cases happened aspiration was 45.00%. Gende,collection time of tracheal secretions, gastric retention volume, way of intubation and intubation depth were founding the influencing factors of aspiration. Conclusion The incidence of aspiration among mechanical ventilated children with enteral nutrition is at a high level. In order to decrease aspiration rate, it is necessary to observe children＇s condition especially in evening, to detect the amount of gastric retention and intubation depth.