综合管理模式在行鼻饲管机械通气患者中的应用研究

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Abstract ObjectiveTo investigate the effect of the standardization management on preventing ventilator-associated pneumonia(VAP)and complications of mechanical ventilation for nasal feeding patients.Methods72 patients with mechanical ventilation in the intensive care unit(ICU)from January to July 2016,they were randomly divided into observation group and control group,36 cases in each groups.The standardization management strategy was implemented in the observation group,including the prevention of ventilator associated pneumonia(VAP)strategy and prevention of enteral nutrition related complications,while the control group was managed as usual ways.Patients of two groups with nasal feeding liquid ingredients with consistency.The nutritional status(serum glutamic-oxaloacetic transaminase,albumin,prealbumin and the level of hemoglobin),VAP,diarrhea,aspiration and the incidence of pathoglycemia(hyperglycemia,hypoglycemina)and the incidence of adverse events(extubation,stomach tube shift,blockage).ResultsAfter nasal feeding,The nutritional status was lower than before (P<0.01).After 14 d,the level of serum glutamic-oxaloacetic transaminase,albumin,prealbumin of observation group were compared with control group,with no significant differences (P>0.05),and only the level of hemoglobin in the observation group was significantly higher than the control group(t= 8.0379,P=0.0000).After 14 d,the incidence of VAP,diarrhea,aspiration,the incidence of hyperglycemia and hypoglycemia in the observation group were significantly lower than those of the control group(P<0.05).The incidence of unplanned extubation,stomach tube shift and blockage in observation group were significantly lower than those of the control group (P<0.05).No significant difference was found in the incidence of gastric retention between the two groups(P>0.05).ConclusionThe standardization management strategy can reduce the incidence of complications of nasal feeding in patients with mechanical ventilation and it is worth wide application.

Key words： Mechanical ventilation Nasal feeding Ventilator associated pneumonia Nutrition Complications

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	GUO Ting
	LIU Hua
	ZhANG Dong-ying

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GUO Ting,LIU Hua,ZhANG Dong-ying. Effect of standardization management in mechanical ventilated patients with nasal feeding[J]. 中国当代医药, 2017, 24(11): 193-197.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2017/V24/I11/193

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