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

1.对30例严重心身障碍的居家管饲患儿进行问卷调查，了解与家庭护理相关的护理问题。其中22例完全管饲，8例部分喂养，偶尔口服。其中30%的人非常苗条，70%的人最近有呼吸道感染史。因此，营养支持和感染控制被确认为护理中的首要问题3。在30名儿童中，有40%的儿童口腔卫生问题严重。母亲们遭受了很大的痛苦，每天花8-10个小时来全面照顾喂养。40%的母亲有焦虑和更换导管的困难，这表明了适当的指导和护理支持的重要性。换管前最频繁的间隔是7天，最长的是20天。细菌学分析显示：(1)1例MRSA阳性，入院时曾插管人工呼吸机；(2)在另外两个管子中也分别发现了少量的大肠杆菌和金黄色假单胞菌。4例MRSA9阴性的患者换管前间隔7d。虽然我们没有分析所有的肺叶，但在广泛使用的7天换管间隔的情况下，似乎没有明显的细菌感染的风险。

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