床旁盲插鼻肠管对重症患者肠内营养喂养效果及并发症的影响

Effect of bedside blind insertion nasointestinal tube on enteral nutrition feeding and complications in critically ill patients

目的:探讨床旁盲插鼻肠管对重症患者肠内营养喂养效果及并发症的影响。方法:选取2018年1月至2019年6月该院重症医学科收治的重症行肠内营养喂养患者62例,根据随机数字表法分为观察组和对照组各31例。对照组行鼻胃管肠内喂养,观察组行床旁盲插鼻肠管肠内喂养。比较两组患者治疗前后误吸、呕吐、胃潴留、腹泻等并发症发生率、7 d喂养达标率、血清总蛋白、白蛋白、前白蛋白、血红蛋白水平及预后情况。结果:观察组患者治疗7 d后血清总蛋白、白蛋白、前白蛋白、血红蛋白水平较对照组显著升高( P<0.05)。观察组7d喂养达标率高于对照组( P<0.05),而误吸、呕吐、胃潴留等并发症发生率低于对照组( P<0.05),但腹泻发生率高于对照组( P<0.05)。观察组机械通气时间、ICU入住时间、总住院时间均短于对照组( P<0.05)。 结论:应用床旁盲插鼻肠管行肠内营养干预能有效提高患者肠内营养喂养达标率,改善重症患者营养状况,降低患者喂养并发症,促进患者康复。

Objective To investigate the effect of bedside blind nasal bowel tube on enteral nutrition and complications in severe patients.Methods From January 2018 to June 2019,62 severe enteral nutrition patients admitted to department of critical care medicine were selected and divided into observation group and control group according to random number table method,31 cases each.The control group was fed with nasogastric tube.The observation group was fed by bedside blind insertion of nasal enteral tube.The incidence of aspiration,vomiting,gastric retention,diarrhea and other complications,feeding compliance rate at 7 days,serum total protein,albumin,prealbumin,hemoglobin level and prognosis were compared between the two groups before and after treatment.Results The serum levels of total protein,albumin,prealbumin and hemoglobin in the observation group were significantly higher than those in the control group 7 days after treatment(P<0.05).The 7-day feeding rate of the observation group was higher than that of the control group(P<0.05).The incidence of complications such as aspiration,vomiting and gastric retention was lower than that of the control group(P<0.05).The incidence of diarrhea was higher than that of the control group(P<0.05).The mechanical ventilation time,ICU stay time and total hospitalization time in the observation group were shorter than those in the control group(P<0.05).Conclusions The application of bedside blind insertion of nasal and intestinal tube for enteral nutrition intervention can effectively improve the rate of enteral nutrition feeding,improve the nutritional status of severe patients,reduce feeding complications and promote the rehabilitation of patients.