集束干预护理在危重患者肠内营养的临床应用

目的:通过对危重患者胃肠内营养进行集束干预管理(Bundle of Care),降低肠内营养(enteral nutrition,EN)并发症,提高危重患者EN的耐受性。方法:选取2011年1月～2011年6月,我院ICU进行EN治疗的112例危重患者(APACHEⅡ评分≥15分)作为研究组,同时选择2009年入住我院ICU行EN治疗的危重患者128例作为常规护理对照组,进行集束化护理的临床病例研究。集束干预护理包括:接受EN患者均给予半卧位,床头抬高30～45度;定时回抽胃内容物,测定胃残液量;防止误吸,预防堵管,预防腹泻措施等综合护理干预措施,分别统计两组腹泻、腹痛、腹胀、恶心、呕吐、误吸等并发症的发生率。结果:危重患者EN并发症对照组为14.06%,研究组为3.57%。差异有统计学意义(P<0.05)。结论:实施集束干预管理对提高危重患者EN耐受性,降低并发症有促进作用。

Bundle Care of ICU Patients with Enteral Nutrition

Objective:To investigate the implementation of synthetic nursing scheme of bundle in ICU patients to reduce the complications and improve tolerance of enteral nutrition.Methods:We choosed the 112 cases of enteral nutrition with bundle care in our hospital ICU during 2011-1～2011-6 as the study group,and 128 patients admitted to the ICU in 2009 with conventional care as the control group,so as to determine the effectiveness of synthetic nursing scheme of bundle.Bundle care include: patients receiving enteral nutrition with semi-recumbent position,head up 30～45 degrees,Withdrawing the stomach contents on time,determining the amount of Gastric residual volumes,preventing aspiration,plugging and diarrhea as well as other Comprehensive nursing interventions.Comparing the incidence of complications with enteral nutrition patients such as diarrhea,abdominal pain,bloating,nausea,vomiting,aspiration in the two group.Results:Complications of enteral nutrition in ICU patients I were14.06% in the contorl group,while the bundle care group’s complications were 3.57%.The difference was statistically significant(P<0.05).Conclusion:It is suggested that the synthetic nursing scheme of bundle play an important role to improve the management of ICUpatients tolerated enteral nutrition and reduce complications.