鼻饲置管深度及体位摆放对神经外科气管切开鼻饲饮食患者食物反流的影响

Influence of depth and position of nasal feeding tube on food reflux in patients with tracheotomy and nasal feeding in neurosurgery

目的探讨鼻饲置管深度及体位摆放对神经外科气管切开鼻饲饮食患者食物反流的影响。方法选择2016年2月~2019年2月我院收治的60例气管切开鼻饲饮食患者作为研究对象,根据随机数字表法分为对照组与观察组,各30例。对照组鼻饲置管深度为50cm左右,取常规仰卧位;观察组在对照组的基础上鼻饲置管深度增加10~15cm,采取头高脚低30°~60°斜坡卧位。比较两组患者置管后不同时间内的胃残留量及不良事件总发生率。结果鼻饲置管30、60、120min后,观察组的胃残留量少于对照组,不良事件总发生率低于对照组,差异有统计学意义(P<0.05)。结论气管切开鼻饲饮食患者进行鼻饲时鼻饲置管深度增加10~15cm并采用头高脚低30°~60°斜坡卧位可加速胃排空,降低吸入性肺炎、食物反流、呛咳及误吸等不良事件发生率,促进患者转归。

Objective To investigate the influence of nasal feeding tube depth and position on food reflux in patients with tracheotomy and nasal feeding in neurosurgery. Methods From February 2017 to February 2019, 60 patients with tracheotomy and nasal feeding were selected as the research objects. According to the random number table method, they were divided into the control group and the observation group, 30 cases in each group. The depth of the nasal feeding tube in the control group was about 50 cm, and the normal supine position was taken. In the observation group, the depth of the nasal feeding tube was increased by 10~15 cm on the basis of the control group, and the head height and foot lower 30°~60° slope were taken. The gastric residue at different time after catheterization and the total incidence of adverse events were compared between the two groups. Results After intranasal feeding for 30 min, 60 min and 120 min, the gastric residue in the observed group was less than that in the control group, and the total incidence of adverse events was lower than that in the control group, with significant differences (P<0 05). Conclusion The nasal feeding tube depth of patients with tracheotomy and nasal feeding can accelerate gastric residue and reduce the incidence of adverse events such as inhaled pneumonia, food reflux, cough and aspiration by increasing the depth of nasal feeding tube and supine position with head high foot and lower 30°~60° slope during nasal feeding of patients with tracheotomy and nasogastric feeding, and promote the outcome of patients.