Effect of nasogastric tube decompression combined with nasointestinal tube nutritional support in the prognosis of patients with severe nervous system diseases

doi:10.3877/cma.j.issn.1674-6880.2017.04.004

Abstract

Abstract:

Objective

To evaluate the effect of nasogastric tube decompression combined with nasointestinal tube nutritional support in the prognosis of patients with severe nervous system diseases.

Methods

A total of 90 patients with severe nervous system diseases were divided into the nasointestinal tube group (n = 45) and the nasogastric tube group (n = 45). The acute physiology and chronic health evaluation (APACHE) Ⅱ and Glasgow coma scale (GCS) were calculated after the patients were recruited into the groups. The levels of albumin and calories gained from enteral nutrition were determined on 1, 7, 14 d after treatment. The incidence of complications, duration of mechanical ventilation, length of ICU stay, total length of hospital stay and mortality rate were also recorded and compared between these two groups.

Results

The APACHE Ⅱ scores [(20.5 ± 6.4) vs. (20.3 ± 6.9)] and GCS scores [(6.1 ± 1.3) vs. (5.5 ± 1.5)] all showed no significant differences in the nasointestinal tube group and the nasogastric tube group (t = 0.140, 0.270; P = 0.888, 0.787). The levels of albumin [(37.5 ± 2.8) g/L vs. (34.2 ± 5.6) g/L] and calories gained from enteral nutrition [(2 147 ± 625) kcal vs. (1 791 ± 768) kcal] on 14 d after treatment in the nasointestinal tube group were both much higher than those in the nasogastric tube group (t = 3.548, 2.412; P = 0.001, 0.017). Meanwhile, the incidence of aspiration pneumonia (5/45 vs. 20/45) and nutrient fluid retention (3/45 vs. 19/45) in the nasointestinal tube group were much lower than those in the nasogastric tube group (χ² = 12.462, 15.401; P = 0.001, 0.001). However, there were no significant differences in the duration of mechanical ventilation (t = 1.149, P = 0.253), length of ICU stay (t = 0.763, P = 0.447), total length of hospital stay (t = 1.251, P = 0.214) and mortality rate (χ² = 0.403, P = 0.525) between the two groups.

Conclusion

Nasogastric tube decompression combined with nasointestinal tube nutritional support at the early stage can improve nutritional status and reduce complications in patients with severe nervous system diseases.

Key words: Nutritional support, Enteral nutrition, Nervous system diseases, Prognosis

Xiaodong Pan, Jingchen Zhang, Luming Tang, Laifang Sun. Effect of nasogastric tube decompression combined with nasointestinal tube nutritional support in the prognosis of patients with severe nervous system diseases[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2017, 10(04): 230-234.

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Figures/Tables 2

References 20

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组别	例数	白蛋白（g/L）			肠内营养热卡（kcal）
组别	例数	1 d	7 d	14 d	1 d	7 d	14 d
鼻肠管组	45	29.6 ± 5.6	30.7 ± 5.3	37.5 ± 2.8	570 ± 134	1 335 ± 523	2 147 ± 625
鼻胃管组	45	31.5 ± 6.1	29.8 ± 3.7	34.2 ± 5.6	574 ± 180	1 339 ± 443	1 791 ± 768
t值	?	1.539	0.934	3.548	0.119	0.039	2.412
P值	?	0.127	0.352	0.001	0.905	0.968	0.017

组别	例数	白蛋白（g/L）			肠内营养热卡（kcal）
组别	例数	1 d	7 d	14 d	1 d	7 d	14 d
鼻肠管组	45	29.6 ± 5.6	30.7 ± 5.3	37.5 ± 2.8	570 ± 134	1 335 ± 523	2 147 ± 625
鼻胃管组	45	31.5 ± 6.1	29.8 ± 3.7	34.2 ± 5.6	574 ± 180	1 339 ± 443	1 791 ± 768
t值	?	1.539	0.934	3.548	0.119	0.039	2.412
P值	?	0.127	0.352	0.001	0.905	0.968	0.017

组别	例数	吸入性肺炎（例）	消化道出血（例）	腹泻（例）	营养液潴留（例）	机械通气时间（d）	ICU住院时间（d）	总住院时间（d）	病死率[（例）%]
鼻肠管组	45	5	11	11	3	10 ± 5	18.2 ± 3.8	36 ± 20	19（42.22）
鼻胃管组	45	20	15	14	19	11 ± 5	18.7 ± 2.2	32 ± 11	22（48.89）
t/χ²值	?	12.462	0.865	0.498	15.401	1.149	0.763	1.251	0.403
P值	?	0.001	0.352	0.480	0.001	0.253	0.447	0.214	0.525

组别	例数	吸入性肺炎（例）	消化道出血（例）	腹泻（例）	营养液潴留（例）	机械通气时间（d）	ICU住院时间（d）	总住院时间（d）	病死率[（例）%]
鼻肠管组	45	5	11	11	3	10 ± 5	18.2 ± 3.8	36 ± 20	19（42.22）
鼻胃管组	45	20	15	14	19	11 ± 5	18.7 ± 2.2	32 ± 11	22（48.89）
t/χ²值	?	12.462	0.865	0.498	15.401	1.149	0.763	1.251	0.403
P值	?	0.001	0.352	0.480	0.001	0.253	0.447	0.214	0.525

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