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[重症监护病房中肠内营养支气管误吸的检测]

[The detection of the bronchial aspiration of enteral nutrition in the ICU].

作者信息

Pérez Cárdenas M D, Ayuso Murillo D, Fernández Hernández A I, Conde Alonso M, Ruiz Ruiz B, Montejo González J C

机构信息

Departamento de Medicina Intensiva, Hospital 12 de Octubre, Madrid.

出版信息

Nutr Hosp. 1992 Mar-Apr;7(2):145-9.

PMID:1571403
Abstract

Description of a comparative study in order to evaluate the sensitivity and reliability of two techniques described in literature used to detect the bronchoaspiration of enteral nutrition. Technique A consists of measuring the glucose in bronchial secretions by strips reactive to glucose-oxidase, and Technique B consists of staining the enteral diets with Methylene Blue, and then watching for the possible presence of colouring in the bronchial secretions. Our study is a contribution to the possible enhancing of the detection of bronchoaspiration, by combining both techniques. A series of 38 patients (Series A) was analyzed, who were subjected to Technique A and a further 32 patients (Series B) were subjected to both Techniques. A comparative study was made on both techniques, based on days of enteral nutrition, and it was observed that the incidence of bronchoaspiration for Series A during the first day of enteral nutrition was 25.7%, and on the following days 9.9%. In Series B, for the first day (Technique A) the percentage of 20% compared to 0% (Technique B), during the following days, 7.2% and 0.93% respectively. We related other variables, in view of their direct handling by the nursing department, such as the pressure used to inflate the pneumoplugging, amount of gastric drainage, administration of antiemetics, the correct position of the nasogastric tube and the presence of peristaltism. The statistical correlation for glucose in bronchial secretions with these variables was not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为评估文献中描述的两种用于检测肠内营养支气管误吸的技术的敏感性和可靠性而进行的一项对比研究。技术A包括使用对葡萄糖氧化酶有反应的试纸测量支气管分泌物中的葡萄糖,技术B包括用亚甲蓝对肠内饮食进行染色,然后观察支气管分泌物中是否有染色。我们的研究通过结合这两种技术,为提高支气管误吸的检测可能性做出了贡献。分析了38例患者(A组),他们接受了技术A,另有32例患者(B组)接受了两种技术。基于肠内营养天数对两种技术进行了对比研究,观察到A组在肠内营养第一天的支气管误吸发生率为25.7%,随后几天为9.9%。在B组中,第一天(技术A)为20%,而技术B为0%,随后几天分别为7.2%和0.93%。考虑到护理部门可直接操作的其他变量,如用于充气封堵的压力、胃引流的量、止吐药的使用、鼻胃管的正确位置以及肠蠕动的存在。支气管分泌物中葡萄糖与这些变量的统计相关性不显著。(摘要截短于250字)

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