幽门后喂养联合伊托必利对老年重症患者医院获得性肺炎发生率的影响

目的探究幽门后喂养联合伊托必利对老年重症患者医院获得性肺炎(HAP)发生率的影响。方法选取2018年3月至2019年12月本院接收的50例老年重症患者作为研究对象,随机分为观察组与对照组,各25例。对照组采取常规喂养方式联合伊托必利治疗,观察组采取幽门后喂养联合伊托必利。观察比较两组HAP发生率、重症持续时间、ICU住院时间、肺炎发生后APACHEⅡ及CPIS评分、临床喂养主要指标。结果观察组患者HAP发生率低于对照组,重症持续时间及ICU住院时间均短于对照组,差异有统计学意义(P<0.05);观察组HAP患者确诊后第14、21天APACHEⅡ评分低于对照组,观察组HAP患者确诊后14、21 d CPISⅡ评分低于对照组,差异有统计学意义(P<0.05);观察组呕吐、胃潴留、显性误吸发生率均低于对照组,差异有统计学意义(P<0.05)。结论幽门后喂养联合伊托必利能有效降低老年重症患者HAP发生率,改善HAP感染后APACHEⅡ与CPIS评分,促进患者康复,改善喂养相关指标。

Effect of post-pyloric feeding combined with itopride on the incidence of hospital-acquired pneumonia in elderly patients

Objective To investigate the effect of post-pyloric feeding combined with itopride on the incidence of hospital-acquired pneumonia(HAP)in elderly patients with severe disease.Methods 50 elderly severely ill patients received in our hospital from March 2018 to December 2019 were selected as study subjects,they were randomly divided into observation group and control group,with 25 cases in each group.The control group was treated with conventional feeding combined with itopride,and the observation group was treated with pyloric feeding combined with itopride.Compare the incidence of HAP,duration of severe illness,hospital stay of ICU,APACHE II and CPIS score changes after pneumonia,and the main indicators of clinical feeding between two groups.Results The incidence of HAP was all lower than that in the control group,and duration of severe illness and hospital stay of ICU in the observation group were all shorter than that in the control group,the difference was statistically significant (P<0.05). The APACHE II scores of HAP patients in the observation group were lower than those of the control group on the 14th and 21stdays after diagnosis, and the CPIS II scores of the HAP patients in the observation group were lower than those of the control group on the 7th, 14th,and 21st days after diagnosis, the difference was statistically significant (P<0.05). The incidence of vomiting, gastric retention, and dominant aspirationin the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). Conclusion Postpyloricfeeding combined with itopride can effectively reduce the incidence of HAP in elderly patients with severe diseases, improve the APACHE IIand CPIS scores after HAP infection, promote patient recovery, and improve feeding related indicators.