电磁显像辅助床旁鼻空肠营养管放置技术在危重患者中的应用  

Use of an electromagnetic device for insertion of bedside nasojejunal feeding tube in critically ill patients

作　　者：刘玉琪[1] 何鲤穗[1] 谭国良[1] 孙旭日[1] 陈志量[1] 

机构地区：[1]福建医科大学附属第二医院重症医学科,泉州362000

出　　处：《中华危重病急救医学》2013年第3期171-173,共3页Chinese Critical Care Medicine

基　　金：基金项目：福建省泉州市科研基金项目（2011249）

摘　　要：目的评价电磁显像辅助库派鼻空肠营养管放置技术在重症监护病房（ICU）中应用的效果。方法回顾性分析2010年1月至2012年9月本院ICU109例行鼻空肠营养管置入术患者的临床资料，按置管技术和营养管类型分为3组：对照1组（48例）采用复尔凯营养管盲视置管，对照2组（28例）采用库派营养管盲视置管，观察组（33例）采用库派营养管电磁显像辅助置管。比较3组置管成功率、置管次数、置管时间及安全性。结果对照2组和观察组置管成功率明显高于对照1组（71．43％、90．91％比33．33％），部分成功率和失败率明显低于对照1组（部分成功率：17．86％、3．03％比35．42％，失败率：10．71％、6．06％比31．25％，均P〈0．05）；而对照2组与观察组比较无明显差异。观察组置管次数明显少于对照1组和对照2组（1．6±0．5比6．6±3．2、5．8±2．3，均P〈0．05），且置管成功者平均置管操作时间（min）较对照1组和对照2组明显缩短（12．48±3．78比25．27±3．61、23．58±4．87，均P〈0．05）；而对照1组和对照2组比较无明显差异。3组患者均无严重相关并发症发生。结论电磁显像辅助库派鼻空肠营养管放置技术成功率高，置管操作时间短、安全，且简单易学。Objective To evaluate the efficacy of an electromagnetic device for correct bedside placement of nasojejunal feeding tube for patients in intensive care unit （ICU）. Methods The clinical data of 109 patients in ICU who accepted bedside nasojejunal feeding tube placement from January 2010 to September 2012 were retrospectively analyzed. All the patients were divided into three groups according to the difference in type of nasojejunal feeding tube and the placement technique： control group 1 （n ：48, Flocare feeding tube and bedside blind insertion group）, control group 2 （n=28, Corflo feeding tube and bedside blind insertion group）, observation group （n=33, Corflo feeding tube and electromagnetic tube placement device group）. The success rate, the times of placement, duration of nasojejunal feeding, and safety were compared among three groups. Results The success rate of control group 2 and observation group were higher than control group 1 （71.43%, 90.91% vs. 33.33%）, rate of partial success and failure rate were lower than those of control group 1 （partial success rate： 17.86%, 3.03% vs. 35.42%; failure rate： 10.71%, 6.06% vs. 31.25%, all P〈0.05）, and no differences were found between control group 2 and observation group. The average times for successful placement in observation group was lower than that of control group 1 and control group 2 （1.6 ±0.5 vs. 6.6 ±3.2, 5.8 ±2.3, both P〈0.05）, and the average time （minutes） for successful placement was shorter in observation group than that of control group 1 and control group 2 （ 12.48 ± 3.78 vs. 25.27 ± 3.61, 23.58 ± 4.87, both P〈0.05）, but there was no difference between control group 1 and control group 2. No complications occurred in all three groups. Conclusion Placement of a nasojejunal tube with the aid of an electromagnetic device is an excellent method for enteral nutrition, as it is safer, more efficient, with high successful rate, less time spending, and easier to master for beginners.

关 键 词：肠内营养 电磁显像技术 鼻空肠营养管 危重病 

分 类 号：R459.3[医药卫生—治疗学]