| Objective: To explore the best replacement time of indwelling gastric tube for very low birth weight and extremely low birth infants.In addition to explore the types,quantity,proportion and antibiotic resistance of the bacterial flora in the gastric tube at the different indwelling time.Methods: A total of 293 cases of very low birth weight infants and extremely low birth weight infants admitted to the neonatal ward of Shengjing Hospital Affiliated to China Medical University from January 2020 to February 2021 were selected.According to the gastric tube indwelling time of 7d,14 d and 21 d,the eligible subjects were randomly divided 1:1:1 into three groups.After the gastric tube reached the expected indwelling time,the gastric tube was pulled out and 1ml normal saline was extracted to flush the gastric tube,so as to simulate 1ml milk delivered through the gastric tube.Bacteriological cultures of irrigating fluid were performed in the laboratory and the cultured bacterial colonies were counted and isolated.Colony name and number were recorded and drug sensitivity test on the contaminated colonies were conducted.General information of the child was recorded,including general information(sex,gestational age,diagnosis,birth weight,mode of delivery),feeding status,laboratory examination,etc.The gastric tube status was also collected.Epidata3.1 software was used to input data,and SPSS20.0 software was used for data analysis.If the measurement data were consistent with normal distribution and homogeneity of variance,it was expressed as mean ± standard deviation((?)±S).One-way ANOVA was used for comparison between groups.If the normal distribution and homogeneity of variance were not satisfied,the median(interquad interval)was used to represent the difference.Kruskal-Wallis test was used for comparison between groups.Enumeration data were described by the number of cases(percentage).Chi-square test was used for comparison between groups,and Fisher’s exact test was used when necessary.P<0.05 was considered statistically significant.Pair comparison was continued for statistically significant data results,and Kappa consistency analysis was used for correlation between gastric tube culture results and blood culture results among multiple groups.Result: There were no statistical differences in the basic information of the children(gender,gestational age,birth weight,delivery mode,feeding mode,and diagnosis)(P>0.05).There were no significant differences in the color,indentation,rebounding angle and integrity of the gastric tube(P>0.05).There were no statistical differences in the pharyngeal mucosa,feeding intolerance,defecation and laboratory infection indexes among the three groups(P>0.05).The difference in daily milk volume among the three groups was statistically significant(P<0.001).Further pairwise comparison was made on daily milk volume showed that there was a difference between Day 7 and Day 21(P = 0.011),and between Day 14 and Day 21(P< 0.001).There was no statistical difference between Day 7 and Day 14(P>0.05).The bacterial flora of gastric tube culture included Klebsiella pneumoniae and Escherichia coli was dominant.There was no significant difference in the species and quantity of microorganism in gastric tube among the three groups(P>0.05)and also no significant difference between breastfeeding and formula feeding(P>0.05).The analysis of drug sensitivity results of Klebsiella pneumoniae and Escherichia coli showed that Escherichia coli cultured in the 21-day group had similar antibiotic resistance except for piperacillin-tazobactam partial resistance(P < 0.05),and the difference was not statistically significant(P>0.05).Conclusion: Long-term indwelling of the gastric tube does not significantly increase the infection of the children.Choosing the polyurethane materials of the gastric tube and adopting the correct nursing method of the gastric tube can appropriately prolong the indwelling time of the gastric tube. |
PDF Full Text Request