经鼻空肠内营养对重型颅脑损伤并发胃肠道反流的疗效观察

目的观察经鼻空肠内营养在重型颅脑损伤并发胃肠道反流患者中的疗效。方法 92例重型颅脑损伤并发胃肠道反流患者,随机分为观察组与对照组,各46例。观察组经鼻空肠内营养支持,对照组经胃管给予营养支持,对比两组患者的临床治疗效果。结果治疗前,观察组患者血清总蛋白、前白蛋白、血红蛋白等指标与对照组比较,差异无统计学意义(P>0.05);治疗2周后,观察组患者血清总蛋白、前白蛋白、血红蛋白等指标均明显优于对照组,差异有统计学意义(P<0.05)。观察组各并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论经鼻空肠内营养在重型颅脑损伤并发胃肠道反流患者中的疗效显著,值得推广。

鼻饲时体位管理对重症脑卒中患者胃肠道反流相关并发症的影响

目的:探讨鼻饲时体位管理对重症脑卒中患者胃肠道反流相关并发症的影响。方法:选取我院重症医学科ICU重症脑卒中患者60例,根据入院先后顺序选取其中30例患者作为对照组,给予常规ICU鼻胃管置入护理;另外30例患者作为观察组,在对照组护理基础上给予患者鼻饲时体位管理。对比两组患者鼻饲相关胃肠道并发症发生率、胃排空时间及平均ICU住院时间。结果:观察组患者鼻饲相关胃肠道并发症发生率明显低于对照组;观察组患者胃排空平均时间及平均ICU住院时间明显短于对照组,差异有统计学意义(P<0.05)。结论:对ICU重症脑卒中患者鼻饲时的体位管理,明显降低了患者胃肠道反流的相关并发症发生率,缩短患者胃排空时间和平均ICU住院时间。

Experimental human pain models in gastro-esophageal reflux disease and unexplained chest pain

Methods related to experimental human pain research aim at activating different nociceptors, evoke pain from different organs and activate specific pathways and mechanisms. The different possibilities for using mechanical, electrical, thermal and chemical methods in visceral pain research are discussed with emphasis of combinations (e.g., the multimodal approach). The methods have been used widely in assessment of pain mechanisms in the esophagus and have contributed to our understanding of the symptoms reported in these patients. Hence abnormal activation and plastic changes of central pain pathways seem to play a major role in the symptoms in some patients with gastro-esophageal reflux disease and in patients with functional chest pain of esophageal origin. These findings may lead to an alternative approach for treatment in patients that does not respond to conventional medical or surgical therapy.