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Objective To observe the clinical effect of Chinese herbal medicine gargle on the prevention of aspiration pneumonia in elderly patients with long-term nasal feeding. Methods 93 elderly patients over 60 years old with indwelling nasogastric tube for 30 days were randomly divided into 48 cases of the experimental group and 45 cases of the control group. We compared incidence of aspiration pneumonia of the elderly patients with long-term nasal feeding in two groups of oral care solution by using the self-made traditional Chinese medicine gargle for oral nursing in the experimental group and treated with saline in the control group. Results The oral bacterial colony count and the incidence of aspiration pneumonia in the experimental group were lower than those in the control group, with two different kinds of nursing fluid. Conclusion Using the self-made traditional Chinese medicine gargle for oral care, could effectively reduce the number of oral bacteria, reduce the incidence of aspiration pneumonia, the application effect is good, and could be in clinical promotion and application.
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Objective:Comparison of oxygen therapy effect between three different enteral nutrition solutions was carried out on AECOPD patients with non-invasive ventilation.Methods:A total of 96 patients with acute exacerbation of COPD were divided into three groups of 32 respectively according to the admission order in this prospective study:a continuous feeding group,an intermittent feeding group,and a regular bolus feeding group.Arterial blood gas parameters including PH,PaO2,PaCO2,PaO2/FiO2 of three groups on third day,fifth day,seventh day were recorded and compared to evaluate the enteral nutrition effect,and meanwhile nutritional support costs,duration of mechanical ventilation,and length of ICU stay between groups were also studied.Results:PH Values of continuous feeding group and intermittent feeding group on 7th day are7.38 ± 0.04、7.39 ± 0.01 respectively,better than that of regular bolus feeding group (P＜ 0.05).ICU stay period and duration of mechanical ventilation for continuous feeding group are 12.83 ± 3.00 days and 9.50 ± 1.45 respectively,for the intermittent feeding group are 11.90 ± 2.35 and 9.59 ± 1.50 respectively,the two groups gain significant cost-effective advantages compared to the regular bolus feeding group.(P ＜ 0.05),for nutrition support costs,continuous feeding is less than the intermittent feeding.(.P ＜ 0.05).Conclusion:Continuous feeding and intermittent feeding could significantly improve hypoxia symptom and reduce the length of ICU stay and shorten duration of mechanical ventilation in COPD patients compared with regular bolus feeding group.
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Objective To design a kind of nasal feeding nutritional tube that can carry 125I particles,to use this tube for the treatment of upper digestive tract malignant occlusive disease in order to achieve double effect of nasal feeding nutrition and brachytherapy.Methods 125I particles were put into a 3F catheter,then both ends of the catheter were sealed off to make 125I particle chain.By using binding technology,the 125I particle chain was fixed on the nasal feeding tube.Under DSA guidance,the nasal feeding tube carrying 125I particle chain was inserted into the esophagus,with the 125I particle chain segment crossing over the section of esophageal stenosis or occlusion to conduct brachytherapy.This technique was employed in 6 patients with advanced esophageal carcinoma.The technical success rate,operation time and complications were recorded.Two months after the treatment,the Karnofsky score,visual analogue scale (VAS) pain score,Neuhaus dysphagia grading,esophagus patency on esophageal radiography,and local tumor control rate were determined.Results The preparation of nasal feeding nutritional tube carrying 125I particle chain was simple.The technical success rate was 100％,the mean operation time was 15.5 min,no serious complications such as bleeding or infection occurred.Two months after the treatment,the Karnofsky score,VAS pain score and Neuhaus dysphagia grading were significantly improved when compared with the preoperative data (P＜0.O1).On esophageal radiography,the contrast agent passed through the narrow area smoothly.Partial remission (PR) of local tumor was obtained in all patients,and the local tumor control rate was 100％.The patients were followed up for 2-6 months,one patient developed recurrent obstruction.Conclusion It is simple and easy to prepare a nasal feeding nutritional tube carrying 125I particle chain,the use of this kind of tube can achieve both parenteral nutrition and brachytherapy at the same time.Therefore,this technique opens a new way for the treatment of esophageal malignant tumor.
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Objective To discuss the influence about three kinds of nasal feeding methods on ICU critical patients with gastrointestinal complications, thus providing guidance for ICU patients to choose reasonable way of nasal feeding pump injection. Methods 120 ICU patients were randomly assigned into three groups, which is the continuous 6-hour and intermittent 2-hour every three time pump group and continuous 24-hours pump group and intermittent 24-hour(continuous 2-hour and intermittent 1-hour every eight time units)pump group ,each group has 40 cases. To observe the the influence about three different way of nasogastric on ICU critical patients with gastrointestinal complications. Results The incidence of diarrhea and constipation among the three groups was not statistically significant (P>0.05) . The gastric retention rate of the continuous 24-hour pump group was significantly higher than that of the continuous 6-hour and intermittent 2-hour pump group and the intermittent 24-hour pump group, the differences were statistically significant (P 0.05). Conclusions The continuous 24-hour pump group in gastric retention was slightly worse than the other two pump way. Compared with ICU class three a week and feeding times , the continuous 6-hour and intermittent 2-hour pump method is more suitable for ICU patients.
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Objective To investigate the effect of swallowing water test in the occurrence of aspiration pneumonia in patients with cerebral infarction. Methods One hundred and twenty?seven cases patients with cerebrovascular disease were randomly divided into two groups:swallow water group and control group,who were guided food program according to the result of swallow water test or experience. The number of two groups to use nasal feeding and the number of cases of the two groups occurred aspiration pneumonia in 3, 6 months were observed. Results The nasal feeding rate of swallow water group was higher than that of control group( 27. 6%( 21/76) vs. 11. 8%( 6/51) ,χ2=4. 590,P=0. 032) . After 3,6 months,the incidence of aspiration pneumonia of control group were higher than that of swallow water group(17. 6%(9/51) vs. 1. 3%(1/76),19. 6%(10/51) vs. 3. 9%(3/76),χ2=9. 080,6. 530,P<0. 05). Conclusion Water?swallowing test is a simple and practical method for assessment risk of aspiration pneumonia of patients with cerebral infarction,which is more effectively to reduce the risk of aspiration pneumonia than the empiric selection method of nasal feeding.
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Objective To observe the effect of continued nursing on the long-term nasal feeding to elderly patients after discharge.Methods Toally 60 elderly discharged patients between January 2014 to December 2014 were evenly divided into observation and control groups with radom digit table the control group received routine nursing before discharge and after it and the observation group received continued nursing.The two groups were compared in terms of nasal feeding-induced complication,nursing satisfaction,care capability of patients' caregivers.Result The complication rate in the observation group was significantly lower,the nursing satisfaction was significantly higher and the care capability of caregivers were significantly better as compared to those of the control group (P ＜0.05).Conclusion Continued nursing can improve nursing satisfaction,train the care capacity of caregivers,reduce the complications for the old patients who need long-term nasal feeding after discharge.
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Objective To explore the risk factors of stroke-associated pneumonia (SAP) in stroke patients. Methods A retrospective study was designed to analyze the clinical data of 159 patients with stroke. They were divided into SAP group (n=35) and non-SAP group (n=124). Their age, gender, hypertension, diabetes mellitus, gastric mucosal protective agents, dysphagia after stroke (DAS), stroke history, type of stroke, hypoproteinemia, disturbance of consciousness, nasal feeding and smoking were analyzed with univariate analysis and multi-variate Logistic regression analysis. Results 22%of the 159 patients suffered from SAP. Univariate analysis showed, there was statistical dif-ference in age (P<0.01), gastric mucosal protective agents (P<0.01), DAS (P<0.01), hypoalbuminemia (P<0.05), disturbance of conscious-ness (P<0.05), nasal feeding (P<0.001) and smoking (P<0.01) between two groups. Binary Logistic regression for the multivariate analysis indicated that age≥70 years old, DAS, nasal feeding and smoking were the risk factors related with SAP. After adjusting for all other vari-ables, the odds of SAP were 5.119 times higher for patients requiring nasal feeding than those without nasal feeding. Conclusion There is a high morbidity for SAP, which is attributed to multiple factors. Age≥70, DAS, nasal feeding and smoking may be the most important risk factors related with SAP.
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Objective To investigate the effect of integrated swallowing function rehabilitation training on nasal feeding patients with pseudobulbar palsy or bulbar palsy after acute ischemic stroke. Methods A total of 54 patients met the diagnosis criteria were enrolled prospectively. They were divided into either an integrated group (n=31)or a control group (n=23)using a random number table method. The patients of the control group received routine treatment of stroke,including brain protection therapy,improvement of cerebral circulation,dehydration,regulating blood pressure,and symptomatic treatment,etc;in addition to conventional treatment,those of the integrated group also received integrated swallowing function rehabilitation training,including neuromuscular electrical stimulation plus swallowing reflex facilitation technique,and oral facial glossopharyngeal function training,etc. The oral intake function in patients of the integration and pseudobulbar palsy or bulbar palsy (according to MRI and signs)was compared between the two groups. The evaluation index was the Functional Oral Intake Scale (FOIS)score. Results (1)The FOIS score (median 4)of the integrated group was higher than that of the control group (median 2). There was significant difference between the two groups (P<0. 01). There was also significant difference before and after comparison between the two groups. (2)The FOIS score of pseudobulbar palsy in the integrated group was higher than that of the control group (median scores 4 and 2 ). There was significant difference (P<0.01);There was no significant difference in the FOIS scores of bulbar palsy between the two groups,but the FOIS score of the integrated group was higher than that of the control group (median scores 4 and 3). (3)The median differences between the integrated group and the control group were 2 and 1 respectively. The increased amplitude of FOIS of the integrated group was higher than that of the control group. There was significant difference (P<0. 01). Conclusion The integrated swallowing function rehabilitation training can improve the oral intake function,significantly reduce irritating cough,increase the capacity of oral intake,and increase the types of food. The effect of the improvement of pseudobulbar palsy is more significant in the integrated group.
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Objective To evaluate the effect of individualized diet nursing on nasogastric gavage-indueced complications after operations on laryngeal cancer? Methods Sixty patients having undergone surgical operation on laryngeal cancer were randomly divided into experiment group and control group in equal number? The control group received nutritional support by conventional enteral nutrition and the experiment group was managed by individualized diet nursing with nasogastric feeding? On days 3 and 10 after operation,the two groups were compared in terms of body constitution,results of experimental tests and complications?Result Compared to the control group,the experiment group showed no significant difference in terms of body constitution and results of experimental tests(P > 0?05)but significantly lower rate of complications on days 3 and 10(P < 0?05)? Conclusion The individualized diet nursing for laryngeal cancer patients may ensure their needs for nutrition,meanwhile reduce the incidences of complications from enteral nutrition,and thus promote their recovery?
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Objective To investigate and improve the methods of nasal feeding to reduce the occurrence of complication such as diarrhea and vomiting.Methods We separated 140 patients with heavy craniocerebral injury into the control group (50 patients) and the experimental group (90 patients) according to different nasal feeding methods. For the control group traditional method was used. For the experimental group infusion pump was used to control infusion rate. The incidence of complication was compared between two groups. And within experimental group, the same nutrient solutions in respect of type and volume were infused during 10 hours, 16 hours, and 18 hours respectively. The relationship between infusion rate and the occurrence of complication was observed, analyzed and compared to seek for the most suitable enteral nutrition route which incurred the least complication.Results The incidence of diarrhea and vomiting in the experimental group was lower than that of the control group. And there were no significant differences in the occurrence of complication by using infusion pump at three different infusion rates within the experimental group. Conclusions The application of infusion pump in nasal feeding can reduce the incidence of complication and infusing nutrient solution at a slow rate was not necessary.
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0.05),but it in thin nasal feeding tube group was significantly lower than that in the other two groups(P