Study Of The Risk Factors Of Tube Feeding Intolerance In The Abdominal Postoperative Period

【Objectives】To find out the risk factors of the tube feeding intolerance in abdominal postoperative period,and make sure the influence of these factors on patients;to formulate the nursing interventions and monitor plans according to these factors.【[Methods】We collected 104 patients who fed by tube more than 7 days,according to the domestic and abroad literatures and the clinical experiences,then consulted the specialists,we made sure the possibly risk factors of tube feeding intolerance in the abdominal postoperative period,the possibly risk factors of abdominal distension were the function of bowel of the day before tube feeding after the operation and the first morning after the tube feeding,the use of relieve pain pump,fasting time,the blood glucoses and gastric residual volumes before and during tube feeding,the location of nutrient tube's extremity,history of diabetes;the possibly risk factors of diarrhea were ALB,drugs and history of diabetes.We analyzed by SPSS15.0 statistics software,blocked these variables and coded them,finded out the significant variables by logistic single factor regression analysis,then lead these significant variables into logistic multiple factor regression analysis,so we found out the risk factors of tube feeding intolerance in the abdominal postoperative period.Then we analyzed every factor by x~2 test,made sure the relationship between different ranges of the factors and intolerance,and then formulated the nursing interventions and monitor plans.【Results】There are few diarchic patients;data are not enough,so we cannot get the results about diarrhea in this study;the use of relieve pain pump,fasting time,the maximum of gastric residual volumes and blood glucoses during tube feeding leaded to the patients who were fed by tube abdominal distending even vomiting;the probability of abdominal distension in patients who were fasted less than 3 days was significantly fewer than in patients who were fasted more than 3 days(P＜0.001);the probability of abdominal distension in patients whose maximum of gastric residual volumes were more than 150mL was more than in patients whose maximum of gastric residual volumes aere less than 150mL(P＜0.001);the probability of abdominal distension in patients whose maximum of blood glucoses were normal(4.4mmol/L～6.1mmol/L)was fewer than in patients whose maximum of blood glucoses were higher than 6.1mmol/L(P＜0.001).【Conclusions】The use of relieve pain pump,fasting time,the maximum of gastric residual volumes and blood glucoses during tube feeding were the risk factors of the abdominal distension;Early enteral nutrition(fasting days≤3)can lessen abdominal distension;The gastric residual volumes should control below 150ml during tube feeding;Abdominal distension during tube feeding is related to the fluctuation of blood glucose;The history of diabetes is not the risk factor of the abdominal distension;Effective nursing intervention can relieve the tube feeding intolerance,while the result should be approached in the future.