危重患者机械通气期间实施肠内营养并发症的护理预防

Nursing prevention of enteral nutrition complications during critical ventilation in critically ill patients

目的探讨危重患者机械通气期间实施肠内营养并发症的护理预防措施。方法选择2016年1月~2017年9月本院收治急性呼吸衰竭患者80例,按照随机数字表法分为两组,每组40例,观察组实施本研究综合护理干预措施,对照组实施常规护理,比较干预后两组热量摄取情况、干预后两组血清蛋白相关指标变化情况及两组出现的肠内营养相关并发症。结果干预后观察组热量摄入量、蛋白摄入和尿素氮生存率均明显大于对照组(P<0.05),干预后观察组转铁蛋白、前白蛋白、白蛋白和总蛋白水平均明显高于对照组(P<0.05),观察组出现肠内营养相关并发症,如腹胀腹痛、肺部感染、恶心呕吐、血糖水平异常及电解质紊乱的比例显著低于对照组(P<0.05)。结论针对危重患者实施机械通气期间肠内营养并发症,实施积极有效的护理干预,能有效提高肠内营养支持效果,减少并发症发生率。

Objective To explore the nursing and preventive measures of enteral nutrition complications in critically ill patients during mechanical ventilation. Methods Eighty cases of acute respiratory failure in our hospital from January 2016 to September 2017 were selected and divided into two groups according to the random number method,40 cases in each group.The observation group was given comprehensive nursing intervention and the control group was given routine nursing.The caloric intake of the two groups after the intervention,the changes of serum protein-related indexes after the intervention and the enteral nutrition-related complications occurred in the two groups were compared. Results After intervention,the calorie intake,protein intake and urea nitrogen survival rate of the observation group were significantly higher than those of the control group （P 〈 O.05）.After intervention,the levels of transferrin,prealbumin,albumin and total protein in the observation group were significantly higher than those in the control group （P 〈 0.05）.The incidence of enteral nutrition-related complications such as abdominal distension,abdominal pain,pulmonary infection,nausea and vomiting,abnormal blood glucose and electrolyte disturbance in the observation group was significantly lower than that in the control group （P 〈0.05）. Conclusion For critically ill patients with mechanical ventilation complications during cnteral nutrition,the implementation of active and effective nursing intervention,can effectively improve the effect of enteral nutrition,reduce the incidence of complications.