不同输注速度对肠内营养液温度影响的研究

Study on the effect of different infusion speeds on the temperature change of enteral nutrient solution

目的探讨人体鼻、咽、食管对经鼻胃管持续输注中的营养液的加温效果。方法采用方便抽样法,选取2020年1月-8月在南京市某三级甲等医院重症医学科住院的42例经鼻胃管持续输注肠内营养液的患者作为研究对象,在营养液无体外加温的情况下,测量并比较患者的体温与不同输注速度(20 ml/h、50 ml/h、70 ml/h、100 ml/h、120 ml/h)下咽部、贲门部营养液温度的差异。结果营养液速度为20 ml/h、50 ml/h、70 ml/h、100 ml/h、120 ml/h对应的咽部营养液温度分别为37.35(36.20,38.20)℃、35.40(34.20,36.70)℃、(33.96±1.80)℃、32.75(30.88,33.63)℃、(31.46±1.55)℃,对应的贲门部营养液温度分别为(37.51±0.86)℃、(37.37±0.88)℃、(37.30±0.85)℃、(37.13±0.86)℃、36.80(36.28,37.60)℃。当营养液输注速度≥50 ml/h时,咽部营液温度与患者体温的差异有统计学意义(P<0.05);营养液输注速度≤100 ml/h时,贲门部营养液温度与患者体温的差异无统计学意义(P>0.05);将患者体温分为3组(36.0~37.0℃、37.1~38.0℃、38.1~39.0℃),在营养液不同输注速度下3组患者贲门部营养液温度与其体温差值的差异均无统计学意义(P>0.05)。结论人体鼻、咽、食管对经鼻胃管持续输注的营养液具有加温作用,且加温效果与营养液输注速度有关,当患者体温在36.0~39.0℃,营养液输注速度≤100 ml/h时,常温营养液到达贲门时温度可接近机体温度。

Objective To investigate the temperature change of enteral nutrition(EN)solution in pharynx and cardia during continuous feeding through a nasogastric tube(NGT)at normal environment temperature.Methods 42 patients with EN support were enrolled by the convenient sampling in the Intensive Care Department of a Level A tertiary hospital in Nanjing.The body temperature of the patients and the EN solution temperature in the NGT(in pharynx and cardia)were measured at different infusion rates(20 ml/h,50 ml/h,70 ml/h,100 ml/h,120 ml/h).Results The temperature of pharyngeal nutrient solution corresponding to the EN solution infusion rates of 20ml/h,50ml/h,70ml/h,100ml/h,120ml/h were 37.35(36.2,38.2)℃,35.4(34.2,36.7)℃,(33.96±1.80)℃,32.75(30.88,33.63)℃,(31.46±1.55)℃.The corresponding temperature of cardiac nutrient solution were(37.51±0.86)℃,(37.37±0.88)℃,(37.30±0.85)℃,(37.13±0.86)℃,36.8(36.28,37.6)℃.When the infusion rate of the EN solution was less or equal to 100 ml/h,there was no significant difference between the EN solution temperature in the cardia and the body temperature of patients(P>0.05).But when the infusion solution rate was≥50 ml/h,there were significant differences between the temperature of pharyngeal camp solution and the patient’s body temperature(P<0.05).There was no significant difference among the EN solution temperature in the cardia and the temperature variation in different body temperature groups(36.0~37.0℃,37.1~38.0℃,38.1~39.0℃)(P>0.05).Conclusion When the EN solution infusion rate was less or equal to 100ml/h and the body temperature ranges between 36.0~39.0℃,the EN solution temperature in cardia is close to the body temperature of the patient.