Abstract：Objective To investigate effect of enteral nutrition by blind insertion of pernasal jejunum tube and gastric tube in their early stage for severe patients in neurosurgical department.Methods A total of 35 ICU patients in neurosurgery department were given blind insertion of spiral nasointestinal tube after 24 to 72 h of admission. The tube was maintained, enteral nutrition was infused accurately, and basic care and complication were strengthened. Another 35 patients with conventional indwelling tube were enrolled in the control group. Results There were 33 cases with successful tube placement, with success rate of 94%. Enteral nutrition was maintained for 10 ~ 15 days.The incidence rates of aspiration and lung infection were effectively reduced, and the levels of albumin, prealbumin, and total iron protein were higher as compared to the control group ( P < 0. 05) .Conclusion Nasointestinal tube in early stage can reduce incidence rate of aspiration and lung inner infection, and effectively obtain enteral nutrition, and improve the nutrional status for severe patients in neurosurgical department.

　　Keyword：grass-root hospital; blind insertion method; nasointestinal tube; neurosurgical department; ICU; enteral nutrition;

　　重型颅脑外伤和急重症脑血管意外的患者, 因不同程度意识障碍、后组颅神经功能障碍导致无法经口进食、吞咽功能障碍、胃瘫, 造成吸入性肺炎、营养不良等并发症, 严重影响预后[1]。营养支持是重症颅脑损伤患者综合治疗的重要组成部分, 基层医院采取留置胃管进行鼻饲匀浆膳, 来满足重症患者的营养需求, 但在鼻饲过程中常存在返流误吸, 导致严重的肺部感染[2-3], 甚至造成脑-肺-脑恶性循环。自2016年本科采用床旁盲插小肠管, 给予肠内营养支持, 食物不易反流, 营养在肠内吸收更充分, 有效降低了误吸的风险和肠源性感染的发生率[4-5]。本研究选择神经外科重症患者徒手床旁行盲插肠管, 并对肠内营养患者进行针对性护理比较研究, 现报告如下。

 

TAG标签： 盲插肠管     临床护     神经外科