急性脑卒中患者鼻饲与肺部感染的临床研究

A Clinical Study The Influence Of Nasal Feeding Tube On The Inidence of Pulmonary Infection in Acute Stroke Patients

目的探讨急性脑卒中合并吞咽困难患者鼻饲管近咽腔段附着物与肺部感染发生的关系。方法选择岳阳市二人民医院2016-04—2017-09治疗的急性脑卒中合并吞咽困难患者120例,随机分为鼻饲组60例,静脉营养组60例;观察评价2组患者在治疗后4周的肺部感染发生率、痰细菌培养及鼻饲管近咽腔段细菌培养情况,并进行比较。结果在治疗后4周鼻饲管组肺部感染发生率高于静脉营养组(P<0.05);鼻饲组治疗4周后肺部感染患者痰细菌培养和同一患者鼻饲管近咽腔段细菌培养为同一细菌感染的共15例,占全部鼻饲组肺部感染病人的75%。结论急性脑卒中合并吞咽困难患者留置鼻饲管4周后鼻饲管近咽腔段附着物可能导致肺部感染发生。

Objective To investigate nasal feeding tube on the incidence of pulmonary infection in acute stroke patients with dysphasia.Methods 120 patients were chosen from Apr 2016 to Sep 2017 and divided into two groups:nasal feeding tube group(60 cases)and parenteral nutrition group as control group(60 cases).The incidences of pulmonary infection in two groups were observed and compared after four weeks.Synchronized bacterial culture was observed from sputum and near the throat of nasal feeding tube in a same patient of nasal feeding tube group.Results The incidences of pulmonary infection were 33.3%and 17.6%in nasal feeding tube group and parenteral nutrition group,respectively.The incidence of pulmonary infection in nasal feeding tube group was obviously higher than those in parenteral nutrition group(P<0.01).Fifteen cases'synchronized bacterial culture was consistent from sputum and near the throat of nasal feeding tube in a same patient of nasal feeding tube group.Conclusion The attachments near the throat of nasal feeding tube may increase the incidence of pulmonary infection in acute stroke patients with dysphasia after four weeks.