推进型鼻空肠导管在重症胰腺炎中的应用研究  

Research on application of propulsive nasal jejunal tube to severe acute pancreatitis

作　　者：冯凯祥[1] 杨培[1] 罗玉君[1] 黄晓丽[1] 王秋蓉[1] 赵红[1] 董伟琼[1] 

机构地区：[1]四川省绵阳市中心医院内镜中心,四川绵阳621000

出　　处：《西南国防医药》2014年第4期361-364,共4页Medical Journal of National Defending Forces in Southwest China

基　　金：四川省绵阳市政府资助科技星火项目(06S042-01);国家专利号(2011201381178)

摘　　要：目的 为重症胰腺炎患者探索一种便捷、安全、成功率高的鼻空肠导管.方法 128例重症胰腺炎患者肠道功能恢复后随机分为：推进型空肠管组64例（实验组）及普通鼻空肠管组64例（对照组）.推进型空肠导管为医用硅胶材料,头端内嵌有一直径0.3 cm钢珠,头端1.5 cm处塑型设计盘状排列的须状结构;普通鼻空肠导管为聚氨酯材料.两组均涂硅油,经鼻孔插入胃45～50 cm;此后,根据胃肠功能情况,每5～30 min,送2～3 cm;达65～70 cm刻度后,间断抽吸空肠管引流液至pH值≥7,继续送管至80 ～ 100 cm刻度为止;从经鼻孔插入开始计时,6h后行X线透视,检查空肠管头端位置.结果 实验组64例,到空肠62例,失败2例,成功率96.88％;对照组64例,成功达空肠28例,失败36例,成功率43.75％;两组成功率有显著性差异（P＜0.01）.置鼻空肠管舒适度比较：实验组舒适51例（79.69％）,痛苦13例（20.31％）;对照组舒适55例（85.93％）,痛苦13例（14.06％）,两组舒适度差异无统计学意义.两组安管时除有恶心、呕吐、咽喉不适外,无一例出现并发症,安放成功后的患者,未见空肠管滑出现象.结论 推进型鼻空肠管价廉、简捷、安全、有效,有推广价值.Objective To invent a simple, safe, and efficient nasal jejunal tube for patients with severe acute pancreatitis. Methods After the recovery of the intestinal function, 128 patients with severe acute pancreatitis were randomly divided into two groups, i. e. propulsive nasal jejunal tube group [ experimental group,64 eases including 54 were male and 10 were female, aged from 24 to 71 （49.23 ± 16.49）] and common nasal jejunal tube group [ control group,64 cases including 51 were male and 13 were female, aged from 25 to 68（45.66 ± 18.38） ]. The propulsive nasal jejunal tube was made from medical silica gel material. It had a steel ball with the diameter of 0.3 cm in the head end. And there was a discoidal whisker at a distance of 1.5 cm from its head end. The tubes were inserted with 45-50 cm into stomach via nostril after the patients were smeared with silicone oil. Then according to the stomach and intestinal functions,the tubes inserted with 2 to 3 cm every 5 to 30 minutes. Until the insertion of 65 to 70 cm tubes, interruptable suction of jejunum drainage was carried out until the pH value was 〉t7. Then the insertion of the tubes was continued to the depth of 80 to 100 cm. The timing of insertion via nostril was recorded,and 6 h later,X-ray was carried out to examine the position of head end. Results The tubes were successfully placed into jejunum in 62 patients of the experimental group （96.88%）, and only two cases failed. But normal nose-intestine nutritional tubes were successfully placed into jejunum in 28 cases of the control group（43.75% ）, and 28 ones failed. There were significant differences in the successful rates between the two groups（P 〈0.01 ）. As to the degree of comfort during the insertion,there were 51 cases felt comfortable（79.69% ）, 13 ones felt painful（20.31% ） in the experimental group and 55 ones felt comfortable（ 85.93% ） and 13 ones felt painful（ 14.06% ） in the control group. The difference between the two groups was not significant. During the p

关 键 词：推进型 鼻空肠管 重症胰腺炎 应用 

分 类 号：R657.51[医药卫生—外科学]