Cov kev ceev faj rau kev saib xyuas khoom noj khoom haus enteral

Kev ceev faj rau kev saib xyuas khoom noj khoom haus enteral yog raws li nram no:
1. Xyuas kom meej tias cov khoom noj khoom haus thiab cov khoom siv infusion yog huv si thiab tsis muaj menyuam
Cov kev daws teeb meem yuav tsum tau npaj rau hauv qhov chaw tsis muaj menyuam, muab tso rau hauv lub tub yees hauv qab 4 ℃ rau kev cia ib ntus, thiab siv li ntawm 24 teev. Lub thawv npaj thiab cov khoom siv infusion yuav tsum tau ceev kom huv si thiab tsis muaj menyuam.

2. Tiv thaiv mucous daim nyias nyias thiab daim tawv nqaij
Cov neeg mob uas nyob rau lub sij hawm ntev indwelling nasogastric tube los yog nasointestinal raj yog feem ntau ua rau ulcers vim tsis tu ncua ntawm lub qhov ntswg thiab pharyngeal mucosa. Lawv yuav tsum tau siv tshuaj pleev ib hnub kom lub qhov ntswg qhov ntswg lubricated thiab ua kom cov tawv nqaij nyob ib ncig ntawm lub fistula huv si thiab qhuav.

3. Tiv thaiv kev aspiration
3.1 Kev tshem tawm ntawm lub plab hnyuv thiab ua tib zoo saib xyuas txoj haujlwm; them nyiaj tshwj xeeb rau kev tswj hwm txoj haujlwm ntawm lub raj nasogastric thaum lub sijhawm tso dej ntawm cov khoom noj khoom haus, thiab tsis txhob txav mus rau sab saud, lub plab zom mov qeeb, thiab cov kua dej yog infused los ntawm lub raj nasogastric lossis gastrostomy, tus neeg mob siv txoj hauj lwm semi-recumbent los tiv thaiv reflux thiab aspiration.
3.2 Ntsuas cov kua dej seem hauv lub plab: thaum lub sij hawm infusion ntawm cov as-ham, tso cov seem seem hauv plab txhua 4 teev. Yog tias nws ntau dua 150 ml, qhov infusion yuav tsum raug tshem tawm.
3.3 Kev soj ntsuam thiab kev kho mob: Thaum lub sij hawm infusion ntawm nutrient tov, tus neeg mob cov tshuaj tiv thaiv yuav tsum tau ua tib zoo soj ntsuam. Thaum hnoos, hnoos ntawm cov qauv tshuaj noj, ua tsis taus pa lossis ua tsis taus pa tshwm sim, nws tuaj yeem txiav txim siab raws li kev xav. Txhawb tus neeg mob kom hnoos thiab ua pa. , Yog tias tsim nyog, tshem tawm cov tshuaj nqus tau los ntawm bronchoscope.

4. Tiv thaiv kev mob plab hnyuv
4.1 Cov teeb meem ntawm catheterization:
4.1.1 Nasopharyngeal thiab esophageal mucosal raug mob: Nws yog tshwm sim los ntawm lub raj tawv dhau, kev ua haujlwm tsis raug lossis lub sijhawm ntev dhau lawm;
4.1.2 Pipeline blockage: Nws yog tshwm sim los ntawm lub lumen yog nyias nyias, cov khoom noj khoom haus yog tuab heev, tsis sib xws, txhaws, thiab cov dej ntws qeeb dhau.
4.2 Cov teeb meem hauv plab hnyuv: xeev siab, ntuav, mob plab, mob plab, raws plab, cem quav, thiab lwm yam, uas yog tshwm sim los ntawm qhov kub thiab txias, ceev thiab concentration ntawm cov khoom noj khoom haus thiab qhov tsis tsim nyog osmotic siab tshwm sim los ntawm nws; nutrient tov pollution ua rau mob plab hnyuv; Cov tshuaj ua rau mob plab thiab raws plab.
Txoj kev tiv thaiv:
1) Lub siab thiab osmotic siab ntawm cov khoom noj khoom haus npaj: Cov khoom noj muaj txiaj ntsig ntau dhau thiab osmotic siab tuaj yeem ua rau xeev siab, ntuav, mob plab thiab raws plab. Pib los ntawm qhov tsis tshua muaj siab, feem ntau pib los ntawm 12% thiab maj mam nce mus rau 25%, lub zog pib los ntawm 2.09kJ / ml thiab nce mus rau 4.18kJ / ml.
2) Tswj cov kua ntim thiab infusion ceev: pib nrog me me ntawm cov kua, qhov pib ntim yog 250 ~ 500ml / d, thiab maj mam ncav cuag lub ntim tag nrho hauv 1 lub lis piam. Tus nqi infusion pib los ntawm 20ml / h thiab maj mam nce mus rau 120ml / h txhua hnub.
3) Tswj qhov kub ntawm cov khoom noj khoom haus: qhov kub ntawm cov khoom noj khoom haus yuav tsum tsis txhob siab dhau los tiv thaiv scalding ntawm plab hnyuv mucosa. Yog tias qis dhau, nws yuav ua rau mob plab, mob plab, thiab raws plab. Nws tuaj yeem ua kom sov sab nraum qhov sib thooj ntawm lub raj pub mis. Feem ntau, qhov ntsuas kub yog tswj ntawm li 38 ° C.
4.3 Cov kab mob sib kis: Aspiration pneumonia yog tshwm sim los ntawm kev tso catheter tsis raug lossis hloov chaw, qeeb plab hnyuv lossis cov kua dej reflux, tshuaj los yog neuropsychiatric mob tshwm sim los ntawm qhov tsis tshua muaj siab.
4.4 Cov teeb meem metabolic: hyperglycemia, hypoglycemia, thiab electrolyte cuam tshuam, tshwm sim los ntawm cov tshuaj tsis sib xws lossis cov mis tsis raug.

5. Kev tu lub raj
5.1 Kho kom raug
5.2 Tiv thaiv kev sib tw, folding, thiab compression
5.3 Ua kom huv si thiab tsis muaj menyuam
5.4 Ntxuav tsis tu ncua