重症患者单导丝幽门后置管法补救性放置螺旋型鼻肠管的临床研究  

Study of using the single stylet method as a bedside remedy after placement of the spiral distal end nasal - enteral feeding tubes in critically ill patients＋

作　　者：叶珩[1] 孙诚[1] 陈纯波[1] 曾文新[1] 陈丽芳[1] 詹伟锋[1] 杨航[1] 

机构地区：[1]广东省人民医院(广东省医学科学院)重症医学科危重病监护二区,广东广州510080

出　　处：《中国急救医学》2013年第12期1082-1084,共3页Chinese Journal of Critical Care Medicine

基　　金：基金项目：广东省科技计划项目（2006B36007016）;广东省医学科学技术研究基金项目（A2007004）

摘　　要：目的探讨对重症患者应用单导丝幽门后置管法补救性放置螺旋型鼻肠管的可行性、安全性和有效性。方法对58例放置螺旋型鼻肠管但不能自行通过幽门的重症患者，采用床边单导丝幽门后置管法放置螺旋型鼻肠管，观察置管成功率和并发症发生率。结果平均置管时间（10．2±3．5）min，置管成功率为81．0％。置管引起患者心率加快[（96．9±10．5）次／min比（101．3±11．1）次／min，P〈0．01]，置管结束后1h心率（96．4±11．0）次／min恢复到置管前水平；置管对呼吸频率、平均动脉压、脉搏容积血氧饱和度无明显影响。未发生严重置管并发症。结论单导丝幽门后置管法放置螺旋型鼻肠管可行、安全、有效，可补救性应用于重症患者。Objective To evaluate the feasibility, safety and efficacy of using the single stylet method as a bedside remedy after placement of the spiral distal end nasal - enteral feeding tubes in critically ill patients. Methods 58 critically iU patients were inserted spiral distal end nasal - enteral feeding tubes into stomach which were unable to pass the pylorus themselves. Monitored by electrocardiograph, the single stylet method as a bedside remedy was taken. The duration, achievement ratio, and complication of the procedure were recorded. Results This procedure took an average time of （10.2 ±3.5） minutes. HR[ （96.9 ± 10.5） bpm vs （ 101.3 ± 11.1）bpm, P 〈0.01] increased during the procedure, but RR, MAP, SpO2 did not. Using the single stylet method, 47 of 58 tubes were successfully intubated. No severe complication was noted. Conclusion The single stylet method can be used safely and effectively in critically ill patients as a bedside remedy after placement of the spiral distal end nasal - enteral feeding tubes.

关 键 词：肠内营养 插管法 螺旋型鼻肠管 危重病 

分 类 号：R651.15[医药卫生—外科学]