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目的:探讨引起神经外科昏迷患者鼻饲反流误吸的危险因素,进一步制定相应的护理管理对策,保证患者安全,有效降低护理纠纷的发生。方法:采用回顾性分析方法,得出胃管粗细与置入深度、鼻饲体位与鼻饲方式及疾病因素是导致神经外科昏迷患者发生鼻饲反流误吸的主要危险因素,进一步采取相应的护理对策,比较实施护理管理对策前后发生反流误吸情况及家属的满意度。结果:实施护理管理后,反流、误吸及吸入性肺炎的发生率明显下降(P<0.05),患者家属满意度明显高于实施前(P<0.05)。结论:加强鼻饲管护理,选择合理的鼻饲体位与鼻饲方式,能够有效降低反流误吸发生率,提高护理质量,保障患者安全,降低病死率。
OBJECTIVE: To explore the risk factors of nasal reflux induced aspiration in patients with neurosurgical coma, further develop corresponding nursing management strategies to ensure the safety of patients and effectively reduce the occurrence of nursing disputes. Methods: Retrospective analysis method was used to draw the conclusion that gastric tube thickness and depth, nasal feeding position and nasal feeding method and disease factors were the main risk factors of nasal reflux regurgitation and aspiration in patients with neurosurgical coma, further nursing measures were taken, Comparison of nursing management measures before and after the occurrence of reflux aspiration and family satisfaction. Results: After nursing management, the incidence of reflux, aspiration and aspiration pneumonia was significantly decreased (P <0.05). The satisfaction of family members was significantly higher than that before implementation (P <0.05). Conclusion: To strengthen the nursing of nasogastric tube and choose a reasonable nasal feeding position and nasal feeding method can effectively reduce the incidence of reflux aspiration, improve nursing quality, ensure patient safety and reduce mortality.