摘要
目的 探讨鼻肠管远端置管于十二指肠球部位置与十二指肠降部对于神经外科监护室幽门后喂养患者吸入性肺炎(AP)、其他喂养并发症及营养状态方面的影响,为幽门后喂养患者吸入性肺炎预防提供证据。方法 研究时间为2021年3月-2023年12月。将徐州医科大学附属医院重症监护病房(ICU)84例患者随机分配到球部组和降部组,各42例,球部组幽门后喂养患者鼻肠管远端置管于十二指肠球部位置,降部组幽门后喂养患者鼻肠管远端置管于十二指肠降部位置。评估指标包括两组患者AP状况(发生率、AP症状持续时间)、喂养并发症,同时对患者的营养状态(白蛋白、前白蛋白、总蛋白及转铁蛋白)进行监测。结果 降部组患者获得性肺炎发生率低于球部组,AP症状持续时间低于降球部组,喂养并发症发生率低于球部组,差异有统计学意义(P<0.05)。喂养前后,两组间白蛋白、前白蛋白、总蛋白及转铁蛋白组间比较差异无统计学意义(P>0.05)。结论 鼻肠管远端置管于十二指肠降部相较于球部位置,能有效降低幽门后喂养患者的吸入性肺炎发生率及减少AP症状持续时间,对预防吸入性肺炎及其并发症具有积极效果,且不影响患者营养状态。
Objective To investigate the effect of placing the distal end of the nasojejunal tube at the duodenal bulb or the descending duodenum on aspiration pneumonia(AP),other feeding complications,and nutritional status in patients receiving post-pyloric feeding in the neurosurgical intensive care unit(ICU),to provide evidence for the prevention of aspiration pneumonia.Methods The study was conducted from March 2021 to December 2023.Eighty-four patients from the intensive care unit(ICU)of Xuzhou Medical University Affiliated Hospital were randomly assigned to the bulb group and the descending group,with 42 patients in each group.In the bulb group,the distal end of the nasojejunal tube was placed in the duodenal bulb position for patients receiving post-pyloric feeding,in the descending group,the distal end of the nasojejunal tube was placed in the duodenal descending position for patients receiving post-pyloric feeding.To evaluate the indicators included AP status(incidence rate,duration of AP symptoms)and feeding complications in two groups,monitoring of patients'nutritional status(albumin,prealbumin,total protein,and transferrin).Results The incidence of AP in the descending group was lower than that in the bulbous group,the duration of AP symptoms was shorter than that in the descending group,and the incidence of feeding complications was lower than that in the bulbous group,with statistically significant differences(P<0.05).There were no statistically significant differences in albumin,prealbumin,total protein,and transferrin levels between the two groups before and after feeding(P>0.05).Conclusion Placing the distal end of the nasojejunal tube in the descending portion of the duodenum rather than the bulbous portion effectively reduces the incidence of aspiration pneumonia and shortens the duration of AP symptoms in patients undergoing post-pyloric feeding.This approach had a positive effect on preventing aspiration pneumonia and the complications without affecting the nutritional status of patients.
作者
张昌启
王跃
张娟娟
刘玉平
吕梦
ZHANG Changqi;WANG Yue;ZHANG Juanjuan;LIU Yuping;LV Meng(Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)
出处
《护理实践与研究》
2025年第10期1517-1521,共5页
Nursing Practice and Research
基金
江苏省人才工作领导小组办公室“333”高层次人才项目(编号BRA2020186)。
关键词
吸入性肺炎
幽门后喂养
神经外科监护室
并发症
神经系统损伤
Aspiration pneumonia
Post-pyloric feeding
Neurosurgical intensive care unit
Complications
Neurological injury
