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[葡萄糖试纸法在鼻饲患者肺部误吸早期检测中的临床意义]

[Clinical implications of the glucose test strip method for early detection of pulmonary aspiration in nasogastric tube- fed patients].

作者信息

Kim Hwa-Soon

机构信息

Department of Nursing, Inha University, Incheon.

出版信息

Taehan Kanho Hakhoe Chi. 2004 Dec;34(7):1215-23. doi: 10.4040/jkan.2004.34.7.1215.

Abstract

PURPOSE

This study was performed to test the clinical usefulness of the glucose test strip method for early detection of pulmonary aspiration in tube fed patients.

METHOD

The subjects for the study were 36 patients who were receiving enteral feedings and 39 patients who were not given enteral feedings. For the analysis, the tube fed patients were divided into two groups (clinically significant aspiration and no aspiration) according to criteria.

RESULT

The mean glucose concentration of tracheal secretions from non enteral fed patients was 26.35 mg/dl and were lower than those concentrations found in tube fed patients (32.75 mg/dl). The mean glucose concentration of the aspiration group was 45.60 mg/dl and the glucose concentration of the non aspiration group was 19.93 mg/dl. The difference was statistically significant (t=2.163, p=. 038). More subjects in the no aspiration group (73%) than the aspiration group (56%) had glucose concentrations below 20 mg/dl. After deleting the cases that had samples containing blood, glucose concentrations of tracheal aspirates were lower in both groups.

CONCLUSION

The glucose level of the aspiration group was significantly lower than the no aspiration group and more subjects in the aspiration group had a glucose level higher than 101 mg/dl. Therefore, the glucose test of tracheal secretions in tube fed patients could be a desirable test for screening for tracheal aspiration. Especially the patient who is showing repeatedly high glucose levels should not be given feedings until reassessment is completed.

摘要

目的

本研究旨在测试葡萄糖试纸法在早期检测管饲患者肺部误吸方面的临床实用性。

方法

本研究的受试者包括36名接受肠内喂养的患者和39名未接受肠内喂养的患者。为进行分析,根据标准将管饲患者分为两组(具有临床意义的误吸组和无误吸组)。

结果

未接受肠内喂养患者的气管分泌物平均葡萄糖浓度为26.35mg/dl,低于管饲患者的浓度(32.75mg/dl)。误吸组的平均葡萄糖浓度为45.60mg/dl,无误吸组的葡萄糖浓度为19.93mg/dl。差异具有统计学意义(t = 2.163,p = 0.038)。无误吸组中葡萄糖浓度低于20mg/dl的受试者(73%)多于误吸组(56%)。在剔除含有血液样本的病例后,两组气管吸出物的葡萄糖浓度均降低。

结论

误吸组的葡萄糖水平显著低于无误吸组,且误吸组中葡萄糖水平高于101mg/dl的受试者更多。因此,管饲患者气管分泌物的葡萄糖检测可能是筛查气管误吸的理想检测方法。特别是对于反复出现高血糖水平的患者,在重新评估完成之前不应给予喂养。

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