昏迷患者鼻饲置管失败原因分析及护理对策  

Causes of nasal feeding intubation failure and nursing counter-measures in coma patients

作　　者：杨松云[1] 

机构地区：[1]南昌市第一医院,江西南昌330008

出　　处：《临床心身疾病杂志》2015年第2期166-167,共2页Journal of Clinical Psychosomatic Diseases

摘　　要：目的：探讨昏迷患者鼻饲置管失败原因及护理对策。方法使用一次性硅橡胃管对昏迷患者进行鼻饲置管，如在置管过程中胃管经鼻腔卷曲入口腔或置管到咽喉部以后拔出为置管失败。结果10例置管失败患者中，3例出现打喷嚏、剧烈咳嗽，3例胃管反折在食管内，2例误入气管而拔出，2例气管插管机械通气患者无法置入。8例经更换导丝胃管、改变体位、调整置入角度等方法后均再次置管成功，其余2例气管插管机械通气患者经多次尝试均置管失败。结论患者病情、操作者经验不足、患者家属的反应以及胃管的选择都会对置管结果产生影响，加强护士培训，做好患者及家属的心理护理和健康教育有利于置管操作顺利进行。Objective To explore the causes of nasal feeding intubation failure and nursing countermeasures in coma patients .Methods Disposable silicone rubber gastric tubes were used for nasal feeding intubation of coma patients ;when gastric tube curled in mouth or was pulled out af‐ter it entered throat ,intubation was considered a failure .Results Three of 10 failure intubation patients developed sneezing and severe cough ,3 had gastric tube reflexed in esophagus ,2 had gastric tube pulled out when it mis‐entered trachea ,2 with trachea cannula mechanical ventilation had no way to intubate . Eight patients were successfully intubated after replacement with guidewire gastric tube ,posture change and insertion angle adjustment ,2 ones with trachea cannula mechanical ventilation failed to intubate after several attempts .Conclusion Patients’ condition ,operators’ experience insufficiency ,relatives’ response and gastric tube choice all have influences on intubation ,it is beneficial to successful intubation to enhance nurse training and to do mental nursing and health education to patients and their families well .

关 键 词：昏迷患者 鼻饲置管 失败原因 护理对策 

分 类 号：R472[医药卫生—护理学]