床旁盲插鼻肠管技术应用于长期卧床患者中的临床效果

Clinical effect of bedside blind nasointestinal tube insertion technique in long-term bedridden patients

目的将床旁盲插鼻肠管技术应用于长期卧床患者,探究临床效果。方法回顾性分析2020年12月至2022年6月于本溪市中心医院接受治疗的60例长期卧床需行肠内营养的患者为研究对象,按照患者对营养供给方式选择分为对照组与观察组,每组30例。对照组男17例、女13例,年龄(65.83±11.65)岁,常规置入胃管供给营养;观察组男18例、女12例,年龄(65.51±11.89)岁,采用床边直接盲插鼻空肠营养管。对比两组患者舒适度、免疫功能、生活质量,记录鼻饲置管相关并发症发生情况。采用t检验、χ^(2)检验。结果置管前,两组患者舒适状况量表(GCQ)评分及免疫球蛋白(Ig)A、IgM、IgG、清蛋白(Alb)、血红蛋白(Hb)、血清转铁蛋白(TF)水平比较,差异均无统计学意义(均P>0.05)。置管7 d后,观察组GCQ评分[(80.36±8.78)分]及IgA[(3.75±0.36)g/L]、IgM[(3.95±0.25)g/L]、IgG[(11.96±2.36)g/L]、Alb[(36.28±4.76)g/L]、Hb[(113.38±15.51)g/L]、TF水平[(275.79±29.15)mg/dl]均明显高于对照组[(73.52±11.82)分、(3.19±0.43)g/L、(3.34±0.17)g/L、(10.63±2.19)g/L、(31.35±4.63)g/L、(108.63±16.64)g/L、(239.35±23.53)mg/dl],差异均有统计学意义(均P<0.05)。置管1个月后,观察组生理功能[(78.23±6.18)分]、心理健康[(76.16±6.35)分]、社会功能[(77.75±6.34)分]、情感职能[(79.12±6.72)分]、活力[(66.90±5.45)分]、躯体疼痛[(72.14±5.67)分]、生理职能[(71.40±6.71)分]、总体健康评分[(74.64±8.58)分]均高于对照组[(71.49±6.67)分、(70.25±6.39)分、(70.27±6.58)分、(70.98±7.06)分、(58.58±5.71)分、(67.28±5.36)分、(64.24±6.46)分、(66.57±8.75)分],差异均有统计学意义(均P<0.05)。置管期间,观察组并发症发生率[10.00%(3/30)]低于对照组[26.67%(8/30)],差异有统计学意义(P<0.05)。结论通过床旁盲插鼻肠管为长期卧床患者进行肠内营养取得不错临床效果,有利于增加患者舒适度,增强免疫功能,降低鼻饲置管并发症发生率,改善营养状况,提升生活质量。

Objective To apply the technique of blind insertion of nasointestinal tube at bedside to long-term bedridden patients and to explore the clinical effect.Methods The study subjects were 60 long-term bedridden patients who needed enteral nutrition in Benxi Central Hospital from December 2020 to June 2022,and they were divided into a control group and an observation group according to their choices of nutrition supply modes,with 30 cases in each group.In the control group,there were 17 males and 13 females,aged(65.83±11.65)years,and the gastric tube was placed routinely for nutrition support.In the observation group,there were 18 males and 12 females,aged(65.51±11.89)years,and the nasointestinal nutrition tube was directly blindly inserted at the bedside.The comfort,immune function,and quality of life of the two groups were compared,and the complications related to nasogastric intubation were recorded.t test and χ^(2) test were used.Results Before catheterization,there were no statistically significant differences in the score of General Comfort Questionnaire(GCQ)and the levels of immunoglobulin(Ig)A,IgM,IgG,albumin(Alb),hemoglobin(Hb),and serum transferrin(TF)between the two groups(all P>0.05).After 7 days of catheterization,the GCQ score[(80.36±8.78)points]and the levels of IgA[(3.75±0.36)g/L],IgM[(3.95±0.25)g/L],IgG[(11.96±2.36)g/L],Alb[(36.28±4.76)g/L],Hb[(113.38±15.51)g/L],and TF[(275.79±29.15)mg/dl]in the observation group were significantly higher than those in the control group[(73.52±11.82)points,(3.19±0.43)g/L,(3.34±0.17)g/L,(10.63±2.19)g/L,(31.35±4.63)g/L,(108.63±16.64)g/L,and(239.35±23.53)mg/dl],with statistically significant differences(all P<0.05).After 1 month of catheterization,the scores of physiological function[(78.23±6.18)points],mental health[(76.16±6.35)points],social function[(77.75±6.34)points],emotional function[(79.12±6.72)points],vitality[(66.90±5.45)points],physical pain[(72.14±5.67)points],physiological role[(71.40±6.71)points],and overall health[(74.64±8.58)points]in the observation group were higher than those in the control group[(71.49±6.67)points,(70.25±6.39)points,(70.27±6.58)points,(70.98±7.06)points,(58.58±5.71)points,(67.28±5.36)points,(64.24±6.46)points,and(66.57±8.75)points],with statistically significant differences(all P<0.05).During catheterization,the incidence of complications in the observation group[10.00%(3/30)]was lower than that in the control group[26.67%(8/30)],with a statistically significant difference(P<0.05).Conclusion Blind insertion of nasointestinal tube by bedside has achieved good clinical results for enteral nutrition for long-term bedridden patients,which helps to increase the patients'comfort,enhance the immune function,reduce the incidence of complications related to nasogastric intubation,improve the nutritional status,and improve the quality of life.