黑龙江医药
黑龍江醫藥
흑룡강의약
HEILONGJIANG MEDICAL JOURNAL
2014年
6期
1295-1295,1296
,共2页
李萍%姜文彬%任常洁%李东梅
李萍%薑文彬%任常潔%李東梅
리평%강문빈%임상길%리동매
呼吸机相关性肺炎%肠内营养%小口径胃管%机械通气%反流误吸
呼吸機相關性肺炎%腸內營養%小口徑胃管%機械通氣%反流誤吸
호흡궤상관성폐염%장내영양%소구경위관%궤계통기%반류오흡
Ventilator-associated pneumonia%Enteral nutrition%Small-diameter nasogastric tube%Mechanical ventilation%Aspi-ration
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。
目的：本文旨在探討對長期腸內營養患者鼻飼時臨床採用小口徑胃管對預防呼吸機相關性肺炎(VAP)的影響。方法：收集2013年5月至2014年2月本院ICU收治的鬚機械通氣且需長期腸內營養患者60例，隨機分為實驗組30例和對照組30例，實驗組選用小口徑（10號）胃管，置管長度為髮跡到劍突的距離再延長10至15㎝。對照組採用臨床常用普通（18號）胃管，常規方法留置。兩組均採用鼻飼泵持續輸註方式進行鼻飼餵養，皆給予常規鼻飼護理措施，兩組間鼻飼量及時間無統計學差異（P>0.05）。觀察實驗組與對照組患者胃內容物反流髮生率、患者鼻飼適應狀況，比較機械通氣2週後兩組患者呼吸機相關性肺炎的髮生率。結果：實驗組胃內容物反流髮生率為6%低于對照組16%，且實驗者患者對鼻飼的適應情況明顯好于對照組。實驗組患者VAP髮生率為5%，對照組為20%，P<0.05具有統計學意義。結論：臨床選用小口徑胃管進行鼻飼可有效減少胃內容物的反流及誤吸，對機械通氣後需要長期進行腸內營養的患者預防呼吸機相關性肺炎具有積極意義。
목적：본문지재탐토대장기장내영양환자비사시림상채용소구경위관대예방호흡궤상관성폐염(VAP)적영향。방법：수집2013년5월지2014년2월본원ICU수치적수궤계통기차수장기장내영양환자60례，수궤분위실험조30례화대조조30례，실험조선용소구경（10호）위관，치관장도위발적도검돌적거리재연장10지15㎝。대조조채용림상상용보통（18호）위관，상규방법류치。량조균채용비사빙지속수주방식진행비사위양，개급여상규비사호리조시，량조간비사량급시간무통계학차이（P>0.05）。관찰실험조여대조조환자위내용물반류발생솔、환자비사괄응상황，비교궤계통기2주후량조환자호흡궤상관성폐염적발생솔。결과：실험조위내용물반류발생솔위6%저우대조조16%，차실험자환자대비사적괄응정황명현호우대조조。실험조환자VAP발생솔위5%，대조조위20%，P<0.05구유통계학의의。결론：림상선용소구경위관진행비사가유효감소위내용물적반류급오흡，대궤계통기후수요장기진행장내영양적환자예방호흡궤상관성폐염구유적겁의의。
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.
