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中华危重症医学杂志(电子版) ›› 2021, Vol. 14 ›› Issue (06) : 472 -475. doi: 10.3877/cma.j.issn.1674-6880.2021.06.006

短篇论著

经鼻空肠内营养防治老年人呼吸机相关性肺炎的临床研究
刘宇1, 徐君1, 郑孝瑜1, 赵凤芝1, 刘晖1, 张丰1, 尹海燕1,()   
  1. 1. 510630 广州,暨南大学附属第一医院重症医学科
  • 收稿日期:2020-09-01 出版日期:2021-12-31
  • 通信作者: 尹海燕

Clinical study of transnasal jejunal nutrition in the prevention and treatment of ventilator-associated pneumonia in the elderly

Yu Liu1, Jun Xu1, Xiaoyu Zheng1   

  • Received:2020-09-01 Published:2021-12-31
引用本文:

刘宇, 徐君, 郑孝瑜, 赵凤芝, 刘晖, 张丰, 尹海燕. 经鼻空肠内营养防治老年人呼吸机相关性肺炎的临床研究[J/OL]. 中华危重症医学杂志(电子版), 2021, 14(06): 472-475.

Yu Liu, Jun Xu, Xiaoyu Zheng. Clinical study of transnasal jejunal nutrition in the prevention and treatment of ventilator-associated pneumonia in the elderly[J/OL]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2021, 14(06): 472-475.

目的

探讨经鼻空肠管肠内营养在预防老年人呼吸机相关性肺炎(VAP)中的作用。

方法

选择2017年4月至2019年6月期间暨南大学附属第一医院综合ICU收治的预计需要机械通气> 48 h、年龄≥ 75岁的114例患者,采用随机数字表法将114例患者分为对照组与观察组,每组各57例。对照组患者采用常规方法留置胃管给予肠内营养,观察组则采用经鼻空肠管给予肠内营养。记录所有患者的临床资料,比较两组患者的VAP发生率、不良反应及预后情况。

结果

观察组患者VAP[10.5%(6 / 57)vs. 24.6%(14 / 57), χ2 = 3.881,P = 0.040]、呕吐[17.5%(10 / 57)vs. 42.1%(24 / 57), χ2 = 0.844,P = 0.002]及腹胀[24.6%(14 / 57)vs. 45.6%(26 / 57), χ2 = 5.546,P = 0.010]发生率均较对照组显著降低;而两组患者腹泻、腹痛、入ICU 7 d内肠内营养达到能量目标、肾脏替代治疗情况、ICU及住院病死率、机械通气时间比较,差异均无统计学意义(P均> 0.05)。

结论

与常规胃管肠内营养相比,经鼻空肠管肠内营养可显著降低老年机械通气患者的VAP发生率。

表1 两组行肠内营养的机械通气老年患者临床资料比较[MP25P75)]
表2 两组行肠内营养的机械通气老年患者VAP、不良反应及预后情况比较[例(%)]
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