间歇性经口至食管管饲法对呼吸系统危重症患者临床疗效的影响

The Effect of Intermittent Oro-esophageal Tube Feeding on the Clinical Efficacy of Patients with Critical Respiratory Diseases

目的:探讨间歇性经口至食管管饲法对危重症患者的临床疗效及不良反应的发生的影响。方法:回顾性分析59例入住重症监护室的危重症患者的临床资料,包括间歇性经口至食管管饲法(intermittent oro-esophageal tube feeding,IOE)的治疗组患者29例,给予持续性鼻胃管管饲的观察组患者30例。比较两组患者的营养风险评估、目标热卡及蛋白质达标评估、操作失败例数、不良反应发生例数,治疗前后吞咽功能恢复评定、血生化指标,住院总费用、住院天数。结果:两组患者的性别、年龄、APACHEⅡ评分、NRS-2002评分、目标热卡及蛋白质达标比较,差异均无统计学意义(P>0.05)。IOE治疗组的不良反应发生率为17.24%,虽低于观察组的40.00%,但差异无统计学意义(P>0.05)。两组患者均未出现严重并发症。治疗前,两组洼田饮水试验时间、吞咽障碍评分、血红蛋白、白蛋白水平比较,差异均无统计学意义(P>0.05);治疗后,治疗组上述指标均优于对照组,差异均有统计学意义(P<0.05)。治疗组的住院费用少于观察组、住院时间短于观察组,差异均有统计学意义(P<0.05)。结论:间歇性经口至食管管饲法在治疗呼吸系统危重症患者中,可提高患者吞咽功能恢复,减低因患者喂养问题导致的器官功能障碍,减少在院天数及住院经济成本,操作简便,患者容易接受,有效改善患者的远期预后。

Objective:To nvestigate the effect of intermittent oral to esophageal feeding on the clinical efficacy and the occurrence of adverse reactions in critically ill patients.Method:The clinical data of 59 critically ill patients admitted to intensive care unit were retrospectively analyzed.Including intermittently through the mouth to the esophagus tube feeding method(intermittent oro-esophageal tube feeding,IOE)in the treatment group of 29 cases the doservation group of 30 cases were given continuous nasogastric tube feeding.The nutritional risk assessment,target calorie calorie and protein standard assessment,the number of cases of operation failure,the number of cases of adverse reactions,the assessment of swallowing function recovery before and after treatment,blood biochemical indicators,the total cost of hospitalization,and the length of hospitalization were compared between the two groups.Result:Two groups of patients’age,gender,APACHEⅡrating,NRS-2002 score,target protein and calorie comparison,the differences were not statistically significant(P>0.05).The incidence of adverse reactions in the IOE treatment group was 17.24%,which was lower than 40.00%in the observation group,but the difference was not statistically significant(P>0.05).No serious complications occurred in either group.Before the treatment,comparison of drinking water test time,deglutition disorder score,hemoglobin and albumin levels in the two groups,the differences were not statistically significant(P>0.05),after treatment,the above indexes in the treatment group were better than those in the control group,the differences were statistically significant(P<0.05).Hospitalization costs were lower in the treatment group than in the observation group,shorter hospital stay than the observation group,the differences were statistically significant(P<0.05).Conclusion:Intermittent oral to esophageal feeding in the treatment of patients with critical respiratory system can improve the recovery of swallowing function,reduce organ dysfunction caused by feeding problems,reduce the days in hospital and the economic cost of hospitalization,easy to operate,patients easy to accept,and effectively improve the long-term prognosis of patients.