重症患者螺旋型鼻肠管置管成功率与APACHEⅡ评分的相关性  

Correlation between APACHEⅡ score and success rate of post-pyloric placement of spiral nasojejunal tube in the critically ill patients

作　　者：张一臣[1] 胡北[2] 陈纯波[2] 叶珩[2] 孙诚[2] 吕波[2] 陈维生[2] 解迪[2] 

机构地区：[1]南方医科大学,广州市510515 [2]广东省人民医院、广东省医学科学院,广州市510080

出　　处：《实用医学杂志》2014年第8期1258-1261,共4页The Journal of Practical Medicine

基　　金：广东省医学科学技术研究基金项目(编号:A2007004);广东省科技计划项目(编号:2006B36007016);广东省医学科研基金项目(编号:B2013011)

摘　　要：目的：探讨重症患者螺旋型鼻肠管幽门后置管成功率与APACHEⅡ评分的相关性。方法：回顾性纳入2006年6月至2013年6月入住本院综合ICU留置螺旋型鼻肠管行肠内营养的患者．共计609例．应用spearman相关分析，验证患者置管成功率与其APACHEⅡ评分间的相关性。根据患者APACHEⅡ评分0～9分、10～19分、20～29分、及≥30分将患者分为4组，验证4组患者置管成功率是否与其组别间存在相关性。同时根据患者是否应用镇静剂及所患基础疾病的种类不同分别分组，进一步验证这种相关性是否依然存在。结果：总体患者置管成功率为40．2％，患者置管成功率与其APACHEⅡ评分间存在相关关系（rs=-0．505，P〈0．01），根据APACHEⅡ评分分组后，各组置管成功率与其组别间存在相关关系（rs＝-1．P〈0．01）。无论患者是否应用镇静剂或患有何种疾病，患者置管成功率与其APACHEⅡ评分间存在负相关关系（rs=-1，P〈0．01）。结论：重症患者所患疾病的严重程度影响其螺旋型鼻肠管幽门后置管成功率。Objective To investigate the correlation between APACHE Ⅱ score and success rate of post- pyloric placement of spiral nasojejunal tube in the critically ill patients. Methods A retrospective study was carried out in 609 patients requiring enteral nutrition （EN） from Jun 2006 to Jun 2013 in Intensive Care Unit （ICU） of Guangdong general hospital. The correlation between APACHE Ⅱ score and success rate of post-pyloric placement was assessed by using the Spearman rank correlation analysis method. All patients were divided into 4 groups according to their own APACHE Ⅱ score. The Spearman rank correlation analysis was used to assess the correlation between the group NO and the success rate of the group in all patients and the patients with or without sedation and the patients with different diseases. Results The total success rate was 40.2%. A negative correlation was found between the APACHE Ⅱ score and the success rate （rs = -0.505, P 〈 0.01）. The negative correlation was still existed in patients with or without sedation and in patients with different diseases （rs = -1, P 〈 0.01 ）. Conclusion The severity of disease affects the success rate of post-pyloric placement of spiral nasojejunal tube.

关 键 词：螺旋型鼻肠管 APACHEⅡ 危重病 镇静剂 胃排空 

分 类 号：R459.7[医药卫生—急诊医学]