Effects Of Different Body Positions And Tube Feeding Methods On Reflux And Aspiration Of Post-traumatic Coma Patients

Objectives To explore the effects of different positions and methods of tube feeding on reflux and aspiration of traumatic coma patients to seek proper feeding methods and prevent aspiration.Methods Altogether 4 research factors including bed head angle, recumbent positions, speed and volume of tube feeding were taken into account during the experiment. The bed head angle factor included three elevations at angles of 0° 30° and 45° , the recumbent positions included left recumbent, right recumbent and supine positions, the feeding speed included 10ml/min, 20ml/min and 30ml/min and the feeding volume included 200ml, 300ml and 400ml. The orthogonal experimental design was adopted and L₂₇(3⁴) design table was applied 27 traumatic coma patients were arranged for different experiments according to result of random combination of the aforesaid four factors and their levels. With Tc⁹⁹-DTPA and food injected into stomach, tube feeding started and time recording commenced. Oropharyngeal and bronchial secretions were suctioned at 1h, 2h,3h, 4h, 5h respectively to detect radioactivity counts, pepsin contents and the glucose content. At the same time, we monitor 24-hour oesophagus pH values and recidual volume to study.Results1. Changes of result for oesophagus pH when different body positions and tube feeding methodsWhen feeding speed varies, reflux episodes, percentage time in reflu(?) and episodes>5min differed significantly. All index were at their lowest when the speed at 10ml/min.2. Changes of technetium (Tc)-99m and pepsin contents when different body positions and tube feeding methodsWhen the bed head angles differ, there were significant difference among the value of radioactivity counts and pepsin contents in the oropharyngeal secretion at 1h and 3h and bronchial secretion at 1h and 2h. The values of radioactivity counts and pepsin at lowest when bed head angled at 30° or 45 ° .When the feeding speeds differ, there were significant difference among the...