Nursing research °Development and clinical application of enteral nutrient solution thermostat *Zhang Wen 1 Wan Cuizhen 2 Liu Lixin 2 Tu Yujie 1 Song Yi 2 Department of General Surgery 2 Department of Nursing, Huangshi City Second Hospital, Hubei Province, Huangshi 435002 abdominal pain, diarrhea; weight And albumin (Alb) value, before the observation group EN, after the end of EN treatment and after EN and the control group, the difference was extremely significant (P<0.01), compared with the control group before and after EN, Alb increased (P <0.01), weight gain was not significant. Conclusion The EN liquid thermostat can ensure the constant temperature of the EN solution, avoid the occurrence of EN complications, and improve the effect of EN adjuvant therapy.
Nutritional support is an important treatment for critically ill and post-gastrointestinal surgery patients. Enteral nutrition (EN) is more direct, safe, economical and effective than parenteral nutrition (PN). However, practice shows that the temperature of EN solution directly affects the therapeutic effect. Too high is easy to damage the gastric mucosa. Too low will lead to accelerated bowel movement. Or intestinal fistula, the patient has abdominal pain, diarrhea. In this regard, the author developed the EN liquid thermostat (hereinafter referred to as the thermostat) in February 1999, which can stabilize the temperature of the EN liquid within the required range. Since it was put into clinical application in April 1999, the development method and clinical effect are reported as follows.
1 thermostat construction and performance 1.1 construction thermostat is divided into four parts: 1 bottle part. The hook consisting of the hook, the inner and outer sleeves and the base shell is made of a stainless steel tube with a diameter of 2 mm; the outer sleeve is thick. 5~1mm stainless steel plate, the upper diameter is gradually reduced to 20mm (lower mouth), like the infusion bottle is inverted; the inner cylinder is made of aluminum plate with thickness of 0.5~1mm (upper mouth diameter 65mm, lower mouth diameter 15mm, height 130mm); base It is made of a stainless steel plate with a thickness of 0.5 to 1 mm (a rectangular parallelepiped of 150 mm < 40 mm), and a 30 mm diameter infusion tube is inserted through the hole from the bottom of the bottom. Set between the inner and outer sleeves. It consists of a sealant and an insulated electric heating wire. The temperature control part is arranged in the base. 4 attachment parts are composed of 2 sensors and corresponding gas expansion type temperature sensors. It consists of temperature display instrument, setting knob, liquid level observation window, lighting, electric safety protection device, wire plug, etc. (see details) 1.2 Working principle After the thermostat is connected to the power supply, the heating wire is heated when the set temperature is reached. After that, the gas expansion type temperature sensor pushes the control contact to disconnect it and stops the power supply; when the temperature is lower than the set temperature, the contact is automatically closed, and the electric heating is repeatedly adjusted so that the temperature is constant within the set range diameter 80mm, high 130mm, from top to bottom at 100mm, Hubei Province, 5 science and technology, fruit, fruit, 00* oil temperature required. Degree f is free to set and adjust, refers to the temperature display instrument display 1.3 main technical parameters high working temperature 100 °C (special application needs to increase the heating wire power), temperature control accuracy ± 1 hook 2 sealant 3 inner cylinder 4 heating wire 5 outer sleeve 6 temperature display instrument 7 temperature setting knob 8 power supply plug 9 liquid level observation window EN liquid thermostat is indicated. 4 test to understand the thermostat temperature adjustment effect, the thermostat was compared with the warm water test: 500ml water heated to 4C was poured into two 250ml volume infusion bottles, respectively, using a thermostat (set 40C) and simple The thermos bottle 13 is kept for 8~10h; the room temperature is controlled at 3 temperature ranges, the drip rate is 100~150ml/h|41, and the water temperature of the infusion tube is measured once every 30min (the temperature difference between the liquid in the bottle and the liquid flowing out of the infusion tube is C) Observing the performance results of the two insulation methods The temperature of the thermostat is kept at 10h (4 (±; the water temperature begins to decrease after 6 hours of simple thermos insulation, and changes with room temperature, that is, the lower the room temperature, the more the water temperature drops, the thermostat There are technical differences with simple thermos insulation. 2 Clinical application 2.1-General data application 340 cases, 70 patients with EN treatment for 20 days were selected for analysis. Among 70 cases, 32 males and 38 females, aged 38-80 years old The average age was 51.9 years. There were 23 cases of severe pancreatitis and 4 cases of pancreatic cancer. 43 cases after gastrointestinal surgery were randomly divided into control group and observation group, 35 cases. The gender age, disease type, condition and number of cases were compared. No significant significance (P>0.05) 2.2 Methods Non-surgical patients were admitted to the hospital 5 days after admission. The patients in the EN group had a room temperature of 10" 150ml/h. The two groups were continuously injected with 350ml of warm water in a container full of EN. Stir with a blender to dissolve completely, then add warm water to the required amount and set 250ml in the infusion bottle, and store the remaining refrigerator in the refrigerator. 3 Place the EN liquid bottle in the thermostat, insert the infusion tube according to the infusion method, and drain it. Air; turn on the power, adjust the temperature knob to 38~40C; connect the nasal jejunal sac tube to adjust the input drip rate. 4 After the input is completed, cut off the power supply, take out the infusion bottle, and dispose of it according to the disposable items;
5 In use, the patient's reaction was observed every 30 minutes; the body weight, albumin (Alb) and other indicators were monitored before and after EN and 71520d, respectively, and recorded to 38~40C. The infusion tube air was drained according to the infusion method, and the nasal jejunal sac tube was connected. , adjust the input drop rate. 4 Put the hot water bottle (water temperature 50~60C) under the infusion tube or next to the EN solution to protect the 5 method with the observation group.
Observation items: record the time of each input of EN liquid and the temperature at the beginning and end of EN liquid, observe the complications (abdominal pain, diarrhea), measure the body temperature and the Alb3 results before and after the end of EN treatment. The efficacy comparison is shown in Table 1. Table 1 The changes of EN fluid in the two groups of patients and the comparison of the efficacy of the group input time weight (kg) began to end before EN EN after EN pre-EN after the control group and the control group corresponding items *P < 001; Before the EN comparison, <0.01, Table 1 shows that the temperature of the EN liquid was constant (P <0.01) Alb and body weight in the observation group per unit time. The observation group was unchanged before and after the EN, while the control group input the EN liquid after 5~11h. After temperature drop and EN, compared with the control group, P<0.01, the difference was extremely significant 18~26C, the temperature difference between the two groups was compared, the difference was extremely significant. The control group before and after EN increased Alb (P 0.01) The weight was not obvious (P>Q complications: 31 cases of abdominal pain and diarrhea in the control group, accounting for 88.6%; no complications occurred in the observation group. 4 Discussion EN helps to improve the systemic nutritional status of patients, which is important for nutritional support therapy. One of the measures. The results of this study show that The temperature control of the thermostat ensures the constant temperature of the EN solution, which is beneficial to the recovery of the gastrointestinal function of the patient, maintains the intestinal and immune functions, effectively avoids the occurrence of complications such as abdominal pain and diarrhea, and alleviates the suffering of the patient. It improves the therapeutic effect of EN. Its advantages: 1 Practical and strong automatic temperature control device can choose the appropriate temperature according to the season, disease sex, age, physical condition, etc. 2 The design is scientific and beautiful, the operation is time-saving and labor-saving, the use is safe and convenient, and the reduction is made. The labor intensity of the nurse 3 can be used for the thermal preservation of the oral nutrient solution, the infusion of the traditional Chinese medicine retention enema, and the like, and can also serve as a solution for dissolving the crystallization liquid.
In order to ensure the smooth progress of EN, it is necessary to pay attention to the nursing: 1 to explain to the patient the purpose of EN adjuvant therapy and the significance of using thermostat insulation to understand and cooperate. 2 Check the power supply and experience and the innovative temperature setting knob before using the thermostat; after the EN liquid is delivered, the nasal jejunal sac tube is separated first, and then the power is cut off to ensure safety. 3 According to the season and the patient's condition, the temperature and speed of the EN liquid are reasonably adjusted, and the patient's reaction is closely observed. 4 The EN solution placed in the refrigerator must be warmed before use, and the infusion bottle is replaced once a day. 5EN is contraindicated in gastrointestinal failure, severe intestinal obstruction, severe abdominal infections* within 1 year of age
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