幽门后喂养在高龄重症患者中应用

目的探讨幽门后喂养在高龄重症患者当中应用的安全性和有效性。方法选取首次需要进行肠内喂养的高龄重症患者100例,随机分为幽门前喂养组(n=50)与幽门后喂养组(n=50)。比较两组间消化道症状及吸入性肺炎的发生率、ICU住院时间、总住院时间及30 d病死率,探讨幽门后喂养的有效性和安全性。结果与幽门前喂养组比较,幽门后喂养组恶心、呕吐、吸入性肺炎发生率较低,但比较容易堵管,差异有统计学意义(P<0.05)。两组患者在腹泻、消化道出血发生率及意外拔管方面比较,差异无统计学意义(P>0.05)。两组间30 d病死率比较,差异无统计学意义(P>0.05);幽门后喂养组ICU住院时间及总住院时间较幽门前喂养组明显减少,差异有统计学意义(P<0.01)。结论在高龄重症患者当中,应用幽门后喂养是安全、有效的,且能明显降低消化道症状及吸入性肺炎的发生概率,降低ICU及总住院时间,减少医疗成本。

Post-pyloric feeding in the elderly patients with critical diseases

Objective To explore the safety and effectiveness of the post-pyloric feeding in elderly patients with critical diseases.Methods A total of 100 elderly patients with critical diseases were randomly divided into the pre-pyloric feeding group(n=50) and the post-pyloric feeding group(n=50).The incidence of gastrointestinal symptoms and aspiration pneumonia,ICU day,hospital day and 30-day mortality were compared between the two groups,the effectiveness and safety of the post-pyloric feeding in elderly patients with critical diseases were analyzed.Results The incidence of nausea,vomiting and aspiration pneumonia in the post-pyloric feeding group were lower,while the tube was easier to be plugged(P<0.05).The incidence of diarrhea,GI bleeding and accidental tube replacement had no statistically significant difference(P>0.05).There were no statistically significant difference of 30-day mortality between the two groups(P>0.05);the ICU day and hospital day in the post-pyloric feeding group were significantly lesser than that in the pre-pyloric feeding group(P<0.01).Conclusion Using post-pyloric feeding in elderly patients with critical diseases is effective and safe,it also reduce the gastrointestinal symptoms and the occurrence of aspiration pneumonia,shorten the length of ICU day and hospital day,and reduce the medical costs.