鼻肠管与鼻胃管肠内营养治疗在ICU脑卒中伴吞咽困难患者中的应用效果比较

Comparison of Application Effect in Stroke Patients Complicated with Dysphagia in ICU between Nasal-intestinal Tube and Nasogastric Tube Guided Enteral Nutrition

目的比较鼻肠管与鼻胃管肠内营养治疗在ICU脑卒中伴吞咽困难患者中的应用效果。方法选取2018年1月-2019年1月河北工程大学附属医院ICU收治的脑卒中伴吞咽困难患者62例,采用随机数字表法分为鼻胃管组和鼻肠管组,每组31例。两组患者入住ICU后均给予常规对症治疗及肠内营养治疗,其中鼻肠管组患者将鼻肠管置入幽门后,鼻胃管组患者将鼻胃管置入胃内;两组患者均连续治疗14 d。比较两组患者治疗前、治疗后14 d血红蛋白(Hb)及白蛋白(Alb)水平、营养风险筛查2002(NRS2002)评分,并记录两组患者治疗期间并发症发生情况。结果治疗前两组患者Hb及Alb水平、NRS2002评分比较,差异无统计学意义(P>0.05);治疗后14 d鼻肠管组患者Hb及Alb水平高于鼻胃管组,NRS2002评分低于鼻胃管组(P<0.05)。治疗期间鼻肠管组患者并发症发生率低于鼻胃管组(P<0.05)。结论与鼻胃管肠内营养相比,鼻肠管肠内营养治疗可更有效地改善ICU脑卒中伴吞咽困难患者营养状况,且安全性更高。

Objective To compare the application effect in stroke patients complicated with dysphagia in ICU between nasal-intestinal tube and nasogastric tube guided enteral nutrition. Methods From January 2018 to January 2019,a total of 62 stroke patients complicated with dysphagia were selected in ICU,the Affiliated Hospital of Hebei University of Engineering,and they were divided into nasogastric tube group and nasal-intestinal tube group according to random number table method,with 31 cases in each group. Patients in the two groups received conventional symptomatic treatment and enteral nutrition,thereinto patients in nasal-intestinal tube group used nasal-intestinal tube,while patients in nasogastric tube group used nasogastric tube;both groups were continuously treated for 14 days. Hb,Alb and NRS2002 score were compared between the two groups before treatment and 14 days after treatment,and incidence of complications was recorded during treatment. Results No statistically significant difference of Hb,Alb or RS2002 score was found between the two groups before treatment(P>0.05);Hb and Alb in nasal-intestinal tube group were statistically significantly higher than those in nasogastric tube group 14 days after treatment,while NRS2002 score in nasal-intestinal tube group was statistically significantly lower than that in nasogastric tube group(P<0.05).Incidence of complications in nasal-intestinal tube group was statistically significantly lower than that in nasogastric tube group during treatment(P<0.05). Conclusion Compared to nasogastric tube guided enteral nutrition,nasal-intestinal tube guided enteral nutrition can more effectively improve the nutritional status in stroke patients complicated with dysphagia in ICU,with higher safety.