鼻肠管和胃管在危重患者中的临床应用及护理比较.docVIP

鼻肠管和胃管在危重患者中的临床应用及护理比较 [摘要] 目的 探讨鼻肠管持续滴注法给危重患者供给营养和胃管间断供给营养的方法在重症患者中的临床应用，比较两种不同插管对危重患者供给营养的效果。 方法 将30例患者随机分为A、B两组，A组采用鼻肠管持续滴注法给危重患者供给营养，B组采用胃管间断供给营养的方法。鼻肠管是经鼻腔插入胃内后通过增强胃蠕动功能促使鼻肠管进入十二指肠或空肠，再经该管持续滴注营养液供给营养。 结果 通过观察鼻肠管组无并发症，普通胃组管并发症为67％，经x2检验，P＜0.1，差别具有显著意义，鼻肠管组效果明显优于普通胃管组。 结论 鼻肠管的应用既保护了患者的胃肠道的正常功能，又减少了许多并发症的发生，值得临床应用和推广。 [关键词] 鼻肠管；胃管；临床应用；护理比较 [Abstract] Objective:To discuss the comparison between Bengmark naso intestinal tube and the common stomach tube regarding clinical application and nursing among critically ill.Methods:30 cases were randomly selected into two groups.One group of patients received the Bengmark naso intestinal tube by insertion through the nasal cavity to the stomach,duodenum or jejunum so as to provide consistent nutrtion .The other group was supplied with nutrition intermittently by using a stomach tube in the conventional way.Results:Through observation ,it was concluded that there is significant difference between the use of Bengmark naso intestinal tube and the conventional stomach tube.No complications were observed when using the Bengmark naso intestinal tube ,whereas 67% of complications occurred when using the stomach tube.Conclusion:Not only does the use of Bengmark naso intestinal tube protect the proper function of the stomach but it also reduce the possibility of occurrence of complications.The common stomach tube has many disadvantages in that it increases the occurrence of complications and suffering of patients. [Key words] Bengmark naso in testinal tube ；Common stomach tube;Clinical application;Nursing effect 重病和创伤均可引起机体代谢的改变，机体长期处于分解代谢大于合成代谢过程中，造成严重营养不良和免疫力低下，可导致多脏器功能不全或衰竭[1]。而早期实施肠内营养，可以改善病人的营养状况，使病情缓解、病程缩短、病死率下降。临床普遍采用胃管间断供给营养的方法，但胃排空差，不能及早实施肠内营养。近年来随着治疗的不断完善，普通胃管供给营养的方法已经不能满足危重患者肠内营养的需要。为了满足危重患者每天的营养需要量，预防和减少并发症，我科自2004年以来采用鼻肠管持续滴注法给危重患者供给营养，既保护患者胃肠道的正常功能，又减少许多并发症的发生。 1 临床资料 1.1 入选对象 选取30例均有部分或全部胃肠功能不全但不能经口进食的老年患者，随机分为A、B 2组，插鼻肠管为A组，插普通胃管为B组。30例中COPD患者28例，格林-巴利综合征患者1例，颅脑外伤患者1例；无创通气14例，有创通气16例；年龄63-87岁；男18例，女12例；鼻肠管经