CAJ | 학술논문

目的：探讨适合高龄卧床患者自制匀浆膳食的每次鼻饲量和鼻饲间隔时间。方法选择住院长期鼻饲自制匀浆膳食的高龄卧床患者60例，随机分为对照组和观察组各30例，在鼻饲置管方法、鼻饲液组成、日鼻饲液总量相同的前提下，对照组按照常规鼻饲方法进行鼻饲，观察组减少鼻饲次数，增加单次鼻饲量。观察患者胃潴留、胃食道反流、误吸、腹胀、腹泻、便秘、血清白蛋白、淋巴细胞总数、次晨空腹微量血糖值、体质量情况。结果两组高龄卧床鼻饲患者并发症比较，观察组胃潴留和胃食道反流明显减少（P<0.05）；鼻饲60 d后观察组患者血清白蛋白、淋巴细胞总数和体质量均高于对照组，差异有统计学意义（P＜0.01），次晨空腹微量血糖比较差异无统计学意义（P＞0.05），观察组日需鼻饲时间、胃排空时间均少于对照组，差异有统计学意义（P<0.01）。结论高龄卧床患者每次400～500 mL的鼻饲量和鼻饲间隔4~5 h有利于减少患者并发症和提高营养状况，并节省护士工作时间，值得推广。
목적：탐토괄합고령와상환자자제균장선식적매차비사량화비사간격시간。방법선택주원장기비사자제균장선식적고령와상환자60례，수궤분위대조조화관찰조각30례，재비사치관방법、비사액조성、일비사액총량상동적전제하，대조조안조상규비사방법진행비사，관찰조감소비사차수，증가단차비사량。관찰환자위저류、위식도반류、오흡、복창、복사、편비、혈청백단백、림파세포총수、차신공복미량혈당치、체질량정황。결과량조고령와상비사환자병발증비교，관찰조위저류화위식도반류명현감소（P<0.05）；비사60 d후관찰조환자혈청백단백、림파세포총수화체질량균고우대조조，차이유통계학의의（P＜0.01），차신공복미량혈당비교차이무통계학의의（P＞0.05），관찰조일수비사시간、위배공시간균소우대조조，차이유통계학의의（P<0.01）。결론고령와상환자매차400～500 mL적비사량화비사간격4~5 h유리우감소환자병발증화제고영양상황，병절성호사공작시간，치득추엄。
Objective To explore the amount of self-made homogenate diet and feeding interval for senior bedridden patients Methods Sixty senior bedridden patients with nasal feeding were randomly divided into control group and experiment group. With the same nasal indwelling tube placement, nasal feeding solution of same ingredient, and equal total amount of feeding solution, conventional nasal feeding was applied in control group while in experiment group, there were less times of nasal feeding and more amount of each feeding. Gastric retention, gastroesophageal reflux, aspiration, abdominal distension, diarrhea, constipation, serum albumin, lymphocyte count, fasting trace blood glucose in next morning and body weight were observed in both groups. Results There were obviously less gastric retention, gastroesophageal reflux in experiment group ( P<0.05) and 60d after nasal feeding, more serum albumin, lymphocyte count and body mass in experiment group, which showed statistical significance ( P<0.01). There was no statistical significance of the comparison of fasting trace blood glucose in next morning ( P>0.05) while there were shorter daily nasal feeding time and gastric emptying time in experiment group (P<0.01). Conclusion For senior bedridden patients, nasal feeding with 400~500 mL per time and feeding interval of 4~5 h is suitable, which is beneficial to reducing the occurrence of complications and saving time.