摘要
目的探讨幽门后喂养用于高龄重症患者的临床有效性及安全性。方法选取山东省泰山疗养院2017年3月至2019年12月住院治疗的高龄重症患者66例为研究对象,采用随机数字表法分为对照组、观察组各33例,对照组患者给予常规鼻胃管喂养营养支持,观察组患者给予幽门后喂养营养支持,两组喂养时间均为14 d。观察两组患者营养状况、病情改善及并发症发生情况。结果喂养后14 d,观察组血清总蛋白(TP)、白蛋白(ALB)、转铁蛋白(TF)、前白蛋白(PA)分别为(62.75±4.22)g/L、(35.38±2.63)g/L、(2.09±0.13)g/L、(221.52±26.62)g/L,均高于对照组的(54.53±4.16)g/L、(32.34±2.83)g/L、(1.85±0.10)g/L、(197.85±25.73)g/L(t=7.969、4.520、8.406、3.673,均P<0.05);喂养后3、7、14 d,观察组急性生理学和慢性健康状况评分系统Ⅱ(APACHEⅡ)分别为(14.04±2.17)分、(10.95±2.21)分、(8.95±2.21)分,均显著低于对照组的(15.98±2.45)分、(13.75±2.25)分、(10.75±2.25)分(t=3.405、5.100、3.279,均P<0.05);观察组重症监护室住院时间为(10.52±1.07)d,显著短于对照组的(14.26±1.05)d(t=14.331,P<0.05);观察组呕吐、胃潴留、显性误吸、吸入性肺炎发生率分别为3.03%(1/33)、12.12%(4/33)、0.00%(0/33)、12.12%(4/33),均显著低于对照组的18.18%(6/33)、33.33%(11/33)、12.12%(4/33)、33.33%(11/33)(χ^2=3.995、4.227、4.258、4.227,均P<0.05)。结论高龄重症患者营养支持方式选用幽门后喂养,可使患者营养状况、病情获得更好地改善,且降低胃潴留、吸入性肺炎等并发症发生率,有较高的有效性和安全性。
Objective:To investigate the clinical efficacy and safety of postpyloric feeding in elderly patients with severe disease.Methods:From March 2017 to December 2019,66 elderly severe patients hospitalized in Taishan Sanatorium of Shandong Province were selected in the study.The patients were divided into control group and observation group according the random digital table method,with 33 cases in each group.The control group received routine nasogastric tube feeding nutrition support,while the observation group received post pylorus feeding nutrition support.The feeding time of both two groups was 14 days.The nutritional status,improvement and complications of the two groups were observed.Results:On the 14th day after feeding,the total serum protein(TP),albumin(ALB),transferrin(TF),prealbumin(PA)in the observation group were(62.75±4.22)g/L,(35.38±2.63)g/L,(2.09±0.13)g/L,(221.52±26.62)g/L,respectively,which were higher than those in the control group[(54.53±4.16)g/L,(32.34±2.83)g/L,(1.85±0.10)g/L,(197.85±25.73)g/L](t=7.969,4.520,8.406,3.673,all P<0.05).On the 3rd,7th and 14th day after feeding,the ApacheⅡ scores of the observation group were(14.04±2.17)points,(10.95±2.21)points,(8.95±2.21)points,respectively,which were significantly lower than those of the control group[(15.98±2.45)points,(13.75±2.25)points,(10.75±2.25)points](t=3.405,5.100,3.279,all P<0.05).The incidences of vomiting,gastric retention,dominant aspiration and aspiration pneumonia in the observation group were 3.03%(1/33),12.12%(4/33),0.00%(0/33),12.12%(4/33),respectively,which were significantly lower than those in the control group[18.18%(6/33),33.33%(11/33),12.12%(4/33),33.33%(11/33)](χ^2=3.995,4.227,4.258,4.227,all P<0.05).Conclusion:Postpyloric feeding used in elderly patients with severe illness can improve the nutritional status and condition of patients,and reduce the incidence of complications such as gastric retention and aspiration pneumonia.It has high efficacy and safety.
作者
高磊
杨雯
Gao Lei;Yang Wen(Department of Critical Medicine,Taishan Sanatorium,Taian,Shandong 211000,China)
出处
《中国基层医药》
CAS
2020年第24期2961-2965,共5页
Chinese Journal of Primary Medicine and Pharmacy
基金
山东省泰安市科技发展计划项目(2018NS0122)。
关键词
危重病
重症监护病房
老年人
80以上
营养支持
插管法
胃肠
幽门
营养状况
肺炎
吸入性
Critical illness
Intensive care units
Aged,80 and over
Nutritional support
Intubation,gastrointestinal
Pylorus
Nutritional status
Pneumonia,aspiration
