| Objective:Compare the application effects of two different feeding techniques of naso jejunal tube feeding and nasogastric tube feeding in infants with esophageal fistula,explore the application value and prospects of naso jejunal tube feeding technology,and Provide more clinical evidence for nutritional support for children with esophageal fistula.Methods:This study selected children with esophageal fistula who were admitted to a third-level A children’s specialty hospital in Jiang xi Province from January 2017 to December 2019 as the research object.A total of 40 children were included in strict accordance with the inclusion and exclusion criteria.The 40 study subjects were randomly divided into control group and intervention group according to the order of admission,with 20 cases in each group.After admission,the two groups of children received routine diagnosis and treatment measures for diseases such as anti-infection,antigastroesophageal reflux,maintaining water and electrolyte stability,and continuous low-pressure suction at the upper end of the esophagus.On this basis,a nasogastric tube was placed in the control group,and a naso-intestinal tube was placed in the intervention group for enteral nutrition.Both milk or breast milk were slowly pumped.The nutrition related indicators,such as total protein,albumin,prealbumin,hemoglobin,lymphocyte count,body weight and other nutrition-related indicators were collected and performed at three time points on the day,7th and 14 th day when the children started enteral nutrition.To compare,collect the general information of the two groups of children,the start time of enteral nutrition,the arrival time of full enteral nutrition,the number of days of combined intravenous nutrition,the incidence of complications,and the cost of treatment.Statistical analysis was performed using SPSS19.0.Results:1.The general information of the two groups of children: age,gender,admission weight,main diagnosis were compared,the difference was not statistically significant(P>0.05),the baseline was at the same level,and it was comparable.2.Nutrition implementation status:(1)Starting time of enteral nutrition:intervention group 16.9 ± 3.71 h,control group 27.75 ± 22.45 h,intervention group enteral nutrition start time is earlier than control group,the difference is statistically significant(P<0.05);(2)The arrival time of full enteral nutrition: the intervention group was 2.05 ± 1.88 days and the control group was 7.65 ± 2.79 days.The intervention group reached the full enteral nutrition earlier than the control group,the difference was statistically significant(P<0.05);(3)During the study period The number of days of combined intravenous nutrition: the number of days of combined intravenous nutrition in the intervention group was 3.13±1.76 days,and that in the control group was 8.45 ± 4.38 days,the difference was statistically significant(P<0.05).3.Nutritional effect: compare the total serum protein(TP),serum albumin(ALB),serum prealbumin(PA),hemoglobin(HB),lymphocyte count(LYM),The weight-for-age Z value(WAZ)level,the results showed:(1)There was no statistically significant difference between the index groups before enteral nutrition treatment(all P>0.05);(2)The difference between the previous and the seventh day of enteral nutrition treatment The index difference was compared between the groups.The results showed that on the 7th day of nutrition,the difference between the two groups of TP,ALB,HB,and LYM before and after nutrition was not statistically significant(all P>0.05),but the PA and WAZ value of the intervention group increased.Compared with the control group,the difference was statistically significant(all P<0.05).(3)Comparing the difference of each index before enteral nutrition treatment and the 14 th day after treatment,the results show that: after 14 days of nutrition,the increase of ALB,PA,HB,WAZ value of the intervention group is greater than that of the control group.The differences were statistically significant(all P<0.05),but the difference in TP,LYM values ? ? between the two groups was not statistically significant(P>0.05).4.Respiratory tract management:(1)The number of airway cleanings in the intervention group was 4.3±0.12 times/day,and the control group was 7.26±0.57times/day.The number of airway cleanings in the intervention group was less than that of the control group,the difference was statistically significant(P<0.05).(2)24-hour continuous negative pressure drainage at the upper end of the esophagus:186.28±24.02 ml in the intervention group,209.20±35.92 ml in the control group.The 24-hour negative pressure drainage at the upper end of the esophagus in the intervention group was less than that in the control group,the difference was statistically significant(P<0.05).5.Nutrition treatment cost: within 14 days of the study period,the nutrition treatment cost of the intervention group(2560.33±1318.60)yuan,the control group(4038.78±2225.10)yuan,the intervention group nutrition treatment cost is less than the control group,the difference is statistically significant(P<0.05).6.Related complications:(1)The incidence of diarrhea: 20.00%(4/20)in the intervention group and 15.00%(3/20)in the control group,the difference was not statistically significant(P>0.05);(2)The incidence of vomiting and aspiration:intervention Group 10.00%(2/20),control group 40.00%(8/20),the difference was statistically significant(P < 0.05);(3)The incidence of accidental extubation:intervention group 10.00%(2/20),control group 40.00 %(8/20),the difference was statistically significant(P<0.05);(4)The incidence of tube blockage: 15.00%(3/20)in the intervention group,0 in the control group,the difference was not statistically significant(P<0.05).Conclusions:1.Naso jejunal tube feeding technology is beneficial for children with esophageal fistula to start enteral nutrition early,reach full enteral nutrition earlier,Provide more enteral nutrition calories,and reduce the application of intravenous nutrition.2.The effect of Naso jejunal tube feeding technology in improving the nutritional status of children with esophageal fistula is better than the nasogastric tube group,and the nutritional status can be significantly improved after 14 days of treatment.3.The application of Naso jejunal tube helps to reduce the increase of res Piratory secretions caused by reflux.4.Naso jejunal tube feeding technology reduces the cost of nutrition treatment for children with esophageal fistula and has good economic benefits.5.Naso jejunal tube feeding in children with esophageal fistula can reduce the risk of vomiting and aspiration,but tube care needs to be strengthened to reduce accidental extubation,tube blockage,diarrhea and other complications. |
PDF Full Text Request