基于澳新风险管理标准在食管癌留置肠内营养管患者中的应用

Application of based on AS-NZS4360 risk management standard in patients with esophageal cancer with enteral-intestinal nutrition tube

目的研究澳新风险管理标准(AS-NZS4360)对食管癌留置肠内营养管患者不良反应发生率的影响。方法选取上海市胸科医院2020年4月至2021年4月经病理学或影像学诊断为食管癌需留置肠内营养管理的患者240例为研究对象。采用随机数字表法将研究对象分为对照组和干预组,每组各120例。对照组采用常规肠内营养护理措施,干预组在常规肠内营养护理基础上AS-NZS4360评估患者并增加相应的针对性护理措施,比较两组肠内营养的不良反应及营养管滑脱、营养管堵塞、营养不良、管道投诉事件等的发生率。结果干预组肠内营养管堵塞、营养不良、管道投诉、腹泻、反流、鼻黏膜损伤的发生率低于对照组,差异有统计学意义(P<0.05)。两组管道投诉、营养管滑脱、胃潴留发生率比较,差异无统计学意义(P>0.05)。结论AS-NZS4360在食管癌留肠内营养管患者中的应用能有效控制各项分组风险的发生率。

Objective To evaluate the application of AS-NZS4360 risk management standard in esophageal cancer patients with enteral-intestinal nutrition tube.Methods From April 2020 to April 2021,240 patients with esophageal cancer diagnosed by pathology or imaging from Shanghai Chest Hospital were selected.The subjects were divided into control group and intervention group by ramdon number table method,with 120 cases in each group.The control group was given routine nursing measures of nasal feeding,and the intervention group was given routine nursing measures of nasal feeding plus targeted nursing measures after risk assessment of AS-NZS4360 risk management standard.The incidence of adverse reactions,catheter slippage,catheter blockage,malnutrition,and nursing complaints were compared between the two groups.Results The incidence of enteral nutrition tube blockage,patients’malnutrition,pipeline complaints,diarrhea,reflux,and nasal mucosal injury in the intervention group was lower than that in the control group,the differences were statistically significant(P<0.05).There were no significant differences in the incidence of pipeline complaints,nutritional tube slippage,and gastric retention(P>0.05).Conclusion Application of AS-NZS4360 in patients with esophageal cancer with enteral nutrition tube can effectively control the incidence of risk in each group.