长期鼻饲老年患者硅胶胃管在胃内留置的安全时间  

Optimal placement time of long-term indwelling stomach tube in elderly patients

作　　者：俞冬丽[1] 叶建虹[1] 胡芝萍[1] 

机构地区：[1]浙江医院普外科,浙江省杭州市310012

出　　处：《世界华人消化杂志》2014年第16期2290-2293,共4页World Chinese Journal of Digestology

摘　　要：目的:探讨长期鼻饲的老年患者胃管在胃内留置的适宜时间,以确保胃管的使用安全,降低并发症发生率.方法:随机选取120例我院老年科留置胃管处理的患者,分为2 wk更换组、3 wk更换组及4wk更换组各40例,对比观察与分析三组患者的胃液pH值、胃管性状(颜色、反折痕、断裂)及鼻咽部黏膜损伤情况(充血、溃疡、水肿、糜烂).结果:胃液pH值及胃管断裂情况,三组差异无统计学意义(P>0.05).胃管颜色及反折痕方面,2及3 wk更换组发生例数均少于4 wk更换组,三组患者差异有统计学意义(P<0.05).2 wk更换组少于4 wk更换组(χ2分别等于25.601、17.144),3 wk更换组少于4 wk更换组(χ2分别等于19.767、13.788).鼻黏膜充血、水肿、糜烂情况,2及3 wk更换组发生例数均少于4 wk更换组,三组患者差异有统计学意义(P<0.05),溃疡情况,三组患者差异无统计学意义(P>0.05).2 wk更换组少于4 wk更换组(χ2分别等于25.858、11.204、13.113,P<0.01),3 wk更换组少于4 wk更换组(χ2分别等于18.825、6.193、13.113,P<0.05).结论:长期接受留置胃管的老年患者,为减轻痛苦,减少并发症发生,胃内留置时间不宜超过3 wk.AIM： To investigate the optimal placement time of the long-term indwelling stomach tube among elderly patients to ensure its safe use and reduce the incidence of complications. METHODS： One hundred and twenty geriatric patients with indwelling stomach tube placement were randomly selected and divided into three groups（two, three and four weeks to replace the tube, respectively）, with 40 patients in each group. Gastric pH, gastric tube traits（color, anti-crease, fracture） and nasopharyngeal mucosal injury（hyperemia, ulceration, edema, erosion） were compared between the three groups. RESULTS： Gastric pH and gastric tube rupture did not differ significantly between the three groups（P ＆gt; 0.05）. The changes in tube color and anti-crease occurred significantly less frequently in the two and three weeks groups than in the four weeks group（χ~2 = 25.601 and 17.144 for the two weeks group; χ~2 = 19.767 and 13.788 for the three weeks group; P ＆lt; 0.05 for all）. Nasal congestion, edema, and erosion occurred significantly less frequently in the two and three weeks groups than in the four weeks group（χ~2 = 25.858, 11.204 and 13.113 for the two weeks group; χ~2 = 18.825, 6.193 and 13.113 for the three weeks group; P ＆lt; 0.05 for all）, while the incidence of ulcer did not differ between the three groups（P ＆gt; 0.05）.CONCLUSION： Placement of long-term indwelling stomach tube in elderly patients should not be more than three weeks in order to relieve pain and reduce complications.

关 键 词：留置胃管 老年患者 适宜时间 

分 类 号：R472[医药卫生—护理学]