Infection nursiug for home care of tube-feeding children with severe psychosomatic disorders

1. 我们对30例重度心身障碍患儿进行家庭管饲问卷调查，以了解与家庭管饲相关的护理问题2。22只全部管饲，8只部分口饲。其中30%极度苗条，70%近期有呼吸道感染史。因此，营养支持和感染控制是护理的首要任务。30名儿童中有40%存在口腔卫生问题。妈妈们承受了很大的痛苦，每天要花8-10个小时来照顾它们的喂养。40%的母亲有焦虑和更换试管的困难，这表明适当的指导和护理支持的重要性。换管前最频繁的间隔为7天，最长的间隔为20天。5根拔管的细菌学分析结果显示：(1)1例患者入院前曾插管人工呼吸机，MRSA阳性。(2)在另外两根试管中也分别检出少量大肠杆菌和金黄色假单胞菌8。其中4例MRSA9阴性，换管间隔为7天。虽然我们没有分析所有的肺叶，但广泛采用7天的管饲交换间隔似乎没有明显的细菌感染风险

1. We conducted a questionnaire survey of 30 in-home tube-feeding children with severe psychosomatic disorders is order to elucidate nursing problems related to the home care2. Twenty two of them were totally tube -fed, 8 were done partially with occasional oral feeding. 30% of them were extremely slim and 70% bad recent histories of respiratory infections. Therefore nutritional support and infection control was confirmed to be of primary concern in the nursing3. 40% of the 30 children bad problems in oral hygiene4. The mothers suffered a great deal, spending 8-10 hours a day for overall care of the feeding5. 40% of the mothers had anxiety and experienced troubles exchanging the tube, which points to the importance of proper guidance and nursing support6. The most frequent interval before exchanging the tube was 7 days with 20 days the longest7. Bacteriological analysis of five removed tubes revealed that (1) MRSA was positive in one case, who had been intubated for artificial respirator d wring previous admission. (2) A small number of Escherichila coli and Pseudomonas Auriginosa were also found separately in two other tubes8. The interval before exchanging the tubes were 7 days in four cases which were negative for MRSA9. Although we had not analyzed all the lobes, there seemed to be no apparent risk of bacteriological infection with widely used 7-day exchange interval for the tube feeding