高龄卧床患者鼻饲自制匀浆膳食鼻饲量和间隔时间的探讨

目的：探讨适合高龄卧床患者自制匀浆膳食的每次鼻饲量和鼻饲间隔时间。方法选择住院长期鼻饲自制匀浆膳食的高龄卧床患者60例，随机分为对照组和观察组各30例，在鼻饲置管方法、鼻饲液组成、日鼻饲液总量相同的前提下，对照组按照常规鼻饲方法进行鼻饲，观察组减少鼻饲次数，增加单次鼻饲量。观察患者胃潴留、胃食道反流、误吸、腹胀、腹泻、便秘、血清白蛋白、淋巴细胞总数、次晨空腹微量血糖值、体质量情况。结果两组高龄卧床鼻饲患者并发症比较，观察组胃潴留和胃食道反流明显减少（P<0.05）；鼻饲60 d后观察组患者血清白蛋白、淋巴细胞总数和体质量均高于对照组，差异有统计学意义（P＜0.01），次晨空腹微量血糖比较差异无统计学意义（P＞0.05），观察组日需鼻饲时间、胃排空时间均少于对照组，差异有统计学意义（P<0.01）。结论高龄卧床患者每次400～500 mL的鼻饲量和鼻饲间隔4~5 h有利于减少患者并发症和提高营养状况，并节省护士工作时间，值得推广。

Amount of Self-made Homogenate Diet and Feeding Interval for Senior Bedridden Patients with Nasal Feeding

Objective To explore the amount of self-made homogenate diet and feeding interval for senior bedridden patients Methods Sixty senior bedridden patients with nasal feeding were randomly divided into control group and experiment group. With the same nasal indwelling tube placement, nasal feeding solution of same ingredient, and equal total amount of feeding solution, conventional nasal feeding was applied in control group while in experiment group, there were less times of nasal feeding and more amount of each feeding. Gastric retention, gastroesophageal reflux, aspiration, abdominal distension, diarrhea, constipation, serum albumin, lymphocyte count, fasting trace blood glucose in next morning and body weight were observed in both groups. Results There were obviously less gastric retention, gastroesophageal reflux in experiment group （P〈0.05） and 60d after nasal feeding, more serum albumin, lymphocyte count and body mass in experiment group, which showed statistical significance （/9〈0.01）. There was no statisticalsignificance of the comparison of fasting trace blood glucose in next morning （P〉0.05） while there were shorter daily nasal feeding time and gastric emptying time in experiment group （P〈0.01）. Conclusion For senior bedridden patients, nasal feeding with 400-500 mL per time and feeding interval of 4-5 h is suitable, which is beneficial to reducing the occurrence of complications and saving time.