规范化鼻饲喂养在降低神经重症患者肠内营养并发症中的应用

Clinical application of standardized nasogastric gavage in reducing enteral nutrition complications of patients with severe craniocerebral trauma

目的探讨规范化鼻饲喂养对神经重症患者肠内营养并发症的影响。方法选取2014年6月至2016年3月98例神经重症患者作为研究对象,按入组先后顺序等分为对照组和干预组,对照组实施传统肠内营养,干预组实施规范化鼻饲喂养,观察不同喂养方式后营养状况指标(白蛋白、前蛋白、转铁蛋白)含量水平,并发症,急性生理学和慢性健康状况评分(APACHE-Ⅱ)及胃肠道评分变化情况。结果两组患者鼻饲前、鼻饲7 d、鼻饲14 d在白蛋白、前蛋白、转铁蛋白含量水平上比较差异均无统计学意义(P> 0. 05);干预组并发症发生率明显低于对照组(P <0. 05);两组鼻饲7 d、鼻饲14 d在胃肠道评分、APACHE-Ⅱ评分上均低于鼻饲前(P <0. 05),且干预组优于对照组(P <0. 05)。结论规范化鼻饲喂养流程能降低神经重症患者肠内营养并发症,改善胃肠道功能。

Objective To explore the effect of standardized nasogastric gavage process on enteral nutrition complications of patients with severe neurosis.Methods A total of 98 patients with severe neurosis from June 2014 to March 2016 were selected as the study subjects.They were divided into the control group and the intervention group with the same number of patients according to the order of enrollment.The control group was treated with traditional enteral nutrition,while patients in the intervention group was fed with standardized nasogastric gavage.The levels of nutritional status index(albumin,proprotein and transferrin),complications,acute physiology and chronic health evaluation(APACHE-II)score,and changes in gastrointestinal tract scores were observed after the implementation of different feeding methods.Results There were no significant statistical differences in albumin,proprotein and transferrin levels between the two groups before nasogastric gavage,as well as at the 7th day and the 14th day of nasogastric gavage(P>0.05).The incidence of complications in the intervention group was significantly lower than that in the control group(P<0.05).The gastrointestinal tract scores and APACHE-II scores of the patients in the two groups at the 7th day and the 14th day of nasogastric gavage were lower than those before nasogastric gavage(P<0.05),and the intervention group was superior to the control group(P<0.05).Conclusion Standardized nasogastric gavage process can reduce intestinal enteral complications and improve gastrointestinal function in patients with severe neurosis.