摘要
目的探讨高龄长期鼻饲患者胃食管反流(gastroesophageal reflux,GER)与胃残余量的相关性及胃食管反流的危险因素。方法选取2017年4-10月在我院住院且经鼻胃管行肠内营养治疗的64例高龄老年男性患者(80~103岁),分别在午餐及晚餐前后30 min收集患者唾液1~3 ml,以乳胶增强免疫比浊法检测唾液中胃蛋白酶原Ⅰ(pepsinogenⅠ,PGⅠ)的浓度,以单次PGⅠ>2.5μg/L为胃食管反流阳性。用白利度计测量患者胃残余量(gastric residuals volume,GRV)。应用Logistics回归分析GER与GRV的相关性以及其他影响GER的因素。结果 53%的高龄老年鼻饲患者GER阳性。多因素Logistics回归分析发现,年龄(OR=0.173,P=0.027)、糖尿病(OR=6.242,P=0.005)及鼻饲方式(OR=5.509,P=0.017)是GER的危险因素,而GRV与GER的发生没有相关性(P>0.05)。结论高龄长期鼻饲患者应采用缓慢滴注的鼻饲方式,对有糖尿病病史的患者要格外关注是否有GER的发生。
Objective To explore the risk factors associated with gastroesophageal reflux in oldest old patients with long-term nasal feeding. Methods Sixty-four elderly patients who underwent nasogastric tube enteral nutrition treatment were chosen in Chinese PLA General Hospital from April 2017 to October 2017. We collected 1-3ml saliva from patients at 30 minutes before and after lunch and dinner. The concentration of pepsinogen Ⅰ（PGⅠ） in saliva was detected by latex enhanced immunoturbidimetry and the result of gastroesophageal reflux（GER） was identified as positive when PGⅠwas〉2.5μg/L at least at one time. Patients＇ gastric residuals volume（GRV） was measured with refractometry. The relationship between GER and GRV and other factors were analyzed by univariate analysis and logistic regression analysis. Results Thirty-four patients（53%） of the enrolled patients were GER positive. There was no correlation between GRV and GER（P 〉0.05）. Multivariate analysis showed that age, diabetes and nasal feeding method were risk factors for GER, with OR values of 4.173, 6.242, and 5.509, respectively. Conclusion Oldest old patients with long-term nasal feeding should be fed by slow drip nasal feeding method. For patients with history of diabetes, we should pay more attention to the occurrence of GER. There is no correlation between the occurrence of GER and GRV.
作者
丁瑜
徐月
王丽媛
侯惠如
DING Yu;XU Yue;WANG Liyuan;HOU Huiru(Chinese PLA General Hospital, Beijing 100853, China)
出处
《解放军医学院学报》
CAS
2018年第5期380-383,共4页
Academic Journal of Chinese PLA Medical School
基金
部委级资助项目
总后勤部卫生部保健专项科研课题(14BJZ05)~~
关键词
胃食管反流
老年人
80岁以上
长期鼻饲
白利度值
胃残余量
gastroesophageal reflux
aged
80 and over
long-term nasal feeding
refractometry
brix value
gastric residual volume
