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目的:观察针刺干预脑卒中合并吸入性肺炎重症患者经螺旋型鼻肠管置管成功率的影响。方法:将46例患者随机分为针刺组(16例)、药物组(15例)、空白组(15例)3组。针刺组采取针刺足三里于插管前期、插管期间、插管结束后进行干预;药物组于置管后鼻饲胃动力药潘立酮进行干预;空白组不采用任何干预措施直接插管。比较三组置管成功率、置管后的并发症及置管前后的营养指标。结果:置管一次性成功率的比较,针刺组优于药物组和空白组,差异均有统计学意义(P<0.05)。置管后并发症比较,针刺组患者腹泻的次数少于药物组和空白组,差异有统计学意义(P<0.05);误吸、便秘和胃残量>250 m L次数比较,差异无统计学意义(P>0.05)。肠内营养指标于置管前和置管后的比较,3组差异均无统计学意义(P>0.05);置管后3组间营养指标比较,针刺组和药物组的血清白蛋白指标比较,差异无统计学意义(P>0.05),但均高于空白组,差异有统计学意义(P<0.05);前白蛋白和血红蛋白指标的比较,3组间比较,差异无统计学意义(P>0.05)。结论:针刺组干预脑卒中合并吸入性肺炎患者鼻肠管置管的成功率优于药物组和空白对照组,且可改善置管后患者的腹泻状况和营养指标血清白蛋白的水平。
Objective: To observe the effect of acupuncture intervention on success rate of spiral naso-intestinal tube insertion in severe stroke patients with aspiration pneumonia. Methods: 46 patients were randomly divided into acupuncture group (16 cases), drug group (15 cases) and blank group (15 cases). Acupuncture group acupuncture Zusanli in the pre-intubation, intubation, intubation after the intervention; drug group in the catheter nasal feeding of gastric pharmacokinetics intervention; blank group without any intervention directly intubation . The successful rate of catheterization, the complications after catheterization and the nutritional indexes before and after catheterization were compared between the three groups. Results: The success rate of catheterization was better than acupuncture group and drug group (P <0.05). Comparing the complications after catheterization, the number of diarrhea in acupuncture group was less than that in drug group and blank group (P <0.05), while the number of aspiration, constipation and gastric residual volume> 250 m L had no difference Statistical significance (P> 0.05). Enteral nutrition before and after catheterization, the three groups were no significant difference (P> 0.05); after the catheterization among the three groups of nutritional indicators, the acupuncture group and the drug group serum albumin index (P> 0.05), but all of them were higher than that of the blank group (P <0.05). There was no significant difference in prealbumin and hemoglobin between the three groups (P> 0.05). CONCLUSION: The success rate of acupuncture group in nasal and intestinal tube insertion in stroke patients with aspiration pneumonia is better than that in drug group and blank control group, and can improve diarrhea status and serum albumin level in patients after catheterization.