小口径胃管的临床应用对预防呼吸机相关性肺炎的研究

Clinical Application of Small-Diameter Nasogastric Tube on Prevention of Ventilator-Associated Pneumonia

目的:本文旨在探讨对长期肠内营养患者鼻饲时临床采用小口径胃管对预防呼吸机相关性肺炎(VAP)的影响。方法:收集2013年5月至2014年2月本院ICU收治的须机械通气且需长期肠内营养患者60例,随机分为实验组30例和对照组30例,实验组选用小口径(10号)胃管,置管长度为发迹到剑突的距离再延长10至15㎝。对照组采用临床常用普通(18号)胃管,常规方法留置。两组均采用鼻饲泵持续输注方式进行鼻饲喂养,皆给予常规鼻饲护理措施,两组间鼻饲量及时间无统计学差异(P>0.05)。观察实验组与对照组患者胃内容物反流发生率、患者鼻饲适应状况,比较机械通气2周后两组患者呼吸机相关性肺炎的发生率。结果:实验组胃内容物反流发生率为6%低于对照组16%,且实验者患者对鼻饲的适应情况明显好于对照组。实验组患者VAP发生率为5%,对照组为20%,P<0.05具有统计学意义。结论:临床选用小口径胃管进行鼻饲可有效减少胃内容物的反流及误吸,对机械通气后需要长期进行肠内营养的患者预防呼吸机相关性肺炎具有积极意义。

Objective:to investigate the effects of useing small-diameter tube on long-term nasogastric enteral nutrition patients for the prevention of ventilator-associated pneumonia (VAP) . Methods:Choose 60 patients of requiring long-term mechanical venti-lation and enteral nutrition from May 2013 to February 2014 and they were equally divided into two groups randomly,including the Experimental group and the control group.The Experimental group was made up of 30 patients as well as the control group was made up of 30 patients.Patients in the Experimental group selected small-caliber (10) tube, tube length is the distance between the xiphoid fortune to further extend 10-15 cm. The control group used clinically normal (18) tube, the conventional method of lien. Both groups were conducted nasal continuous infusion pump nasogastric feeding tube feeding and both were given the routine nursing nasal volume and time between the two groups was no significant difference (P>0.05). Observed patients of gastric contents reflux incidence and ad-aptation in patients with nasal.Comparison the incidence of ventilator-associated pneumonia after mechanical ventilation 2 weeks of the two groups of patients. Results:Experimental group stomach contents reflux rate was 6%lower than the control group (16%), and the experimenter adaptation nasogastric patients was significantly better than the control group. VAP occurred in patients ofthe experi-mental group was 5%,the control group was 20%, and the difference was statistically significant(p<0.05). Conclusions:Tthe using of small-caliber nasogastric tube in clinical can be effective in reducing stomach contents reflux and aspiration, with positive implica-tions to prevent ventilator-associated pneumonia of the long-term mechanical ventilation patients.