CAJ | 학술논문

目的：了解加强护理对机械通气肠内营养患者呼吸机相关肺炎的预防作用，进一步探讨针对该类患者的合理护理干预措施。方法选择惠州市中心人民医院神经外科因不同原因致昏迷且需行机械通气支持的危重患者80例，随机分为实验组及对照组，患者各40例，其中，实验组在机械通气期间实施鼻胃管肠内营养，对照组实施肠外营养，分别对两组患者实施有差别的护理干预措施，比较两组患者在呼吸机相关肺炎发生率方面的差异。结果实验组40例患者中并发呼吸机相关肺炎8例（8/40），对照组并发呼吸机相关肺炎6例(6/40)，两组患者在呼吸机相关肺炎发生率方面的差异无统计学意义（P>0.05）。结论机械通气期间实施肠内营养是安全的，其中，增加胃管长度留置、抬高床头、间断匀速泵入营养液、监测残胃量、适时增加胃动力药物等加强护理措施对于预防该类患者呼吸机相关肺炎的发生具有肯定意义。
목적：료해가강호리대궤계통기장내영양환자호흡궤상관폐염적예방작용，진일보탐토침대해류환자적합리호리간예조시。방법선택혜주시중심인민의원신경외과인불동원인치혼미차수행궤계통기지지적위중환자80례，수궤분위실험조급대조조，환자각40례，기중，실험조재궤계통기기간실시비위관장내영양，대조조실시장외영양，분별대량조환자실시유차별적호리간예조시，비교량조환자재호흡궤상관폐염발생솔방면적차이。결과실험조40례환자중병발호흡궤상관폐염8례（8/40），대조조병발호흡궤상관폐염6례(6/40)，량조환자재호흡궤상관폐염발생솔방면적차이무통계학의의（P>0.05）。결론궤계통기기간실시장내영양시안전적，기중，증가위관장도류치、태고상두、간단균속빙입영양액、감측잔위량、괄시증가위동력약물등가강호리조시대우예방해류환자호흡궤상관폐염적발생구유긍정의의。
Objective To understand preventive effect of the strengthening nursing to the ventilator-associated pneumonia in patients treated by enteral nutrition combining with mechanical ventilation, to make further study for reasonable nursing measures. Methods 80 critically ill patients in neurosurgery department of Huizhou municipal central hospital who needed mechanical ventilation because of coma. Then all cases were randomly divided into two groups, 40 cases as experimental group, 40 cases as control group. During mechanical ventilation, using nasogastric tube enteral nutrition in experimental group, and using parenteral nutrition in control group, then respectively using different nursing measures to tow groups. Results 8 cases were complicated with the ventilator-associated pneumonia in 40 cases experimental group (8/40), and 6 cases were complicated with the ventilator-associated pneumonia in 40 cases control group (6/40), there were not statistical significance in the incidence of the ventilator-associated pneumonia in tow groups (P>0.05). Conclusion During mechanical ventilation, using enteral nutrition is safe. Strengthening nursing measures, including increasing the length of indwelling gastric tube to experimental group, elevating the bed head, pumping nutrient solution into under discontinuous uniform motion, monitoring residual gastric content, using timely gastric motor drug, and so on, is positive significance to prevent the occurrence of the ventilator-associated pneumonia in the patients of enteral nutrition of mechanical ventilation.