早期幽门后喂养在重症脑血管疾病患者中的应用价值(1)
摘要：目的 探討早期床边徒手盲插鼻肠管幽门后喂养在重症脑血管病患者中的临床价值。方法 选择我院2019年1～12月收治的重症脑血管病患者72例，按随机数字表法分为观察组(37例)与对照组(35例)，对照组经鼻胃管进行肠内营养，观察组采取床边徒手盲插鼻肠管幽门后喂养进行肠内营养。比较两组治疗第3、7及14天的营养指标(白蛋白、前蛋白和血红蛋白水平)、营养支持相关并发症发生率及转归情况(机械通气时间、ICU住院时间和28 d死亡率)。结果 治疗第3天，两组白蛋白、前蛋白、血红蛋白水平比较，差异无统计学意义(P>0.05);治疗第7、14天，观察组白蛋白、前蛋白水平高于对照组，差异有统计学意义(P<0.05)，但血红蛋白水平与对照组比较，差异无统计学意义(P>0.05);观察组营养支持相关并发症发生率为40.54%，低于对照组的77.14%，差异有统计学意义(P<0.05);观察组机械通气时间、ICU住院时间分别为(162.23±50.37)h和(14.05±1.96)d，均短于对照组的(204.32±59.21)h和(15.78±2.08)d，差异有统计学意义(P<0.05);两组28 d死亡率比较，差异无统计学意义(P>0.05)。结论 早期床边徒手盲插鼻肠管幽门后喂养在重症脑血管患者中的应用效果优于鼻胃管，有助于改善患者营养水平，加快患者恢复，减少住院时间，安全性较高，值得应用。
关键词：肠内营养;盲插鼻肠管;幽门后喂养;重症脑血管病
中图分类号：R459.7 文献标识码：A DOI：10.3969/j.issn.1006-1959.2020.13.024
文章编号：1006-1959(2020)13-0090-03
Application Value of Early Post-pyloric Feeding in Patients with Severe Cerebrovascular Disease
LOU Xia-ru1，WU Xiang1，HU Gui-fang2，LI Ping1
(Department of Intensive Medicine1，Department of Nutrition2，Central Hospital of Chancheng District，Foshan 528031，Guangdong，China)
Abstract：Objective To explore the clinical value of early bedside blind insertion of nasal enteral tube and pylorus in patients with severe cerebrovascular disease.Methods 32 patients with severe cerebrovascular disease admitted to our hospital from January to December 2019 were selected and divided into observation group (37 cases) and control group (35 cases) according to random number table method.The control group was given enteral nutrition through the nasogastric tube， and the observation group was fed blindly by the bedside and inserted into the pylorus of the nasointestinal tube for enteral nutrition.Comparison of nutritional indicators (albumin， preprotein and hemoglobin levels)， incidence of nutritional support-related complications and outcomes (mechanical ventilation time， ICU hospital stay and 28-day mortality rate) on the 3rd， 7th and 14th days of treatment between the two groups.Results On the third day of treatment， there was no statistically significant difference in the levels of albumin， preprotein， and hemoglobin between the two groups (P>0.05); On the 7th and 14th days of treatment， the levels of albumin and preprotein in the observation group were higher than those in the control group，the difference was statistically significant (P<0.05)， but compared with the control group， the difference in hemoglobin level was not statistically significant (P>0.05); The incidence of nutritional support-related complications in the observation group was 40.54%， lower than 77.14% in the control group， the difference was statistically significant (P<0.05); the mechanical ventilation time and ICU hospitalization time of the observation group were (162.23±50.37)h and (14.05±1.96) d， both shorter than (204.32±59.21) h and (15.78±2.08) d of the control group， the difference was statistically significant (P<0.05); 28-day mortality rate between the two groups was not statistically significant Significance (P>0.05).Conclusion Early bedside blind hand insertion of nasointestinal tube and pylorus feeding in patients with severe cerebrovascular disease is better than nasogastric tube， which can improve the nutritional level of patients， accelerate the recovery of patients， reduce the length of hospitalization， and has high safety. It is worth applying., 百拇医药(娄侠儒 吴翔 胡桂芳 李萍)
关键词：肠内营养;盲插鼻肠管;幽门后喂养;重症脑血管病
中图分类号：R459.7 文献标识码：A DOI：10.3969/j.issn.1006-1959.2020.13.024
文章编号：1006-1959(2020)13-0090-03
Application Value of Early Post-pyloric Feeding in Patients with Severe Cerebrovascular Disease
LOU Xia-ru1，WU Xiang1，HU Gui-fang2，LI Ping1
(Department of Intensive Medicine1，Department of Nutrition2，Central Hospital of Chancheng District，Foshan 528031，Guangdong，China)
Abstract：Objective To explore the clinical value of early bedside blind insertion of nasal enteral tube and pylorus in patients with severe cerebrovascular disease.Methods 32 patients with severe cerebrovascular disease admitted to our hospital from January to December 2019 were selected and divided into observation group (37 cases) and control group (35 cases) according to random number table method.The control group was given enteral nutrition through the nasogastric tube， and the observation group was fed blindly by the bedside and inserted into the pylorus of the nasointestinal tube for enteral nutrition.Comparison of nutritional indicators (albumin， preprotein and hemoglobin levels)， incidence of nutritional support-related complications and outcomes (mechanical ventilation time， ICU hospital stay and 28-day mortality rate) on the 3rd， 7th and 14th days of treatment between the two groups.Results On the third day of treatment， there was no statistically significant difference in the levels of albumin， preprotein， and hemoglobin between the two groups (P>0.05); On the 7th and 14th days of treatment， the levels of albumin and preprotein in the observation group were higher than those in the control group，the difference was statistically significant (P<0.05)， but compared with the control group， the difference in hemoglobin level was not statistically significant (P>0.05); The incidence of nutritional support-related complications in the observation group was 40.54%， lower than 77.14% in the control group， the difference was statistically significant (P<0.05); the mechanical ventilation time and ICU hospitalization time of the observation group were (162.23±50.37)h and (14.05±1.96) d， both shorter than (204.32±59.21) h and (15.78±2.08) d of the control group， the difference was statistically significant (P<0.05); 28-day mortality rate between the two groups was not statistically significant Significance (P>0.05).Conclusion Early bedside blind hand insertion of nasointestinal tube and pylorus feeding in patients with severe cerebrovascular disease is better than nasogastric tube， which can improve the nutritional level of patients， accelerate the recovery of patients， reduce the length of hospitalization， and has high safety. It is worth applying., 百拇医药(娄侠儒 吴翔 胡桂芳 李萍)