超声引导下床旁鼻空肠管置入术在危重患者肠内营养中的应用  

Application of ultrasound-guided bedside nasal-jejunal catheterization in enteral nutrition of critically-ill patients

作　　者：亓志玲[1] 贺银燕 李宗强 马爱英[1] 徐洪英 QI Zhiling;HE Yinyan;LI Zongqiang;MA Aiying;XU Hongying(Department of Intensive Care Medicine,Affiliated Hospital of Jining Medical University,Jining,Shandong,272029)

机构地区：[1]济宁医学院附属医院重症医学科,山东济宁272029

出　　处：《中西医结合护理（中英文）》2019年第1期110-113,共4页Journal of Clinical Nursing in Practice

基　　金：济宁医学院附属医院苗圃科研计划项目(MP-2016-023)

摘　　要：目的探讨超声引导下床旁鼻空肠管置入术在危重患者肠内营养中的应用效果。方法将112例危重患者随机分为对照组与观察组,各56例。对照组行胃内注气盲置鼻肠管肠内营养干预,观察组行超声引导下床旁鼻空肠管置入干预。比较2组置管成功率、并发症发生率、营养指标水平等情况。结果观察组一次性置管成功率高于对照组(87. 50%vs. 71. 43%,P <0. 05);观察组导管幽门通过、到达胃部、总置管及达到目标营养值时间均短于对照组,置管费用少于对照组(P <0. 05);观察组导管移位的发生率均明显低于对照组(P <0. 05);置管营养7d后,对照组体质量指数(BMI)及营养指标水平均明显低于置管前(P <0. 05),观察组BMI及营养指标水平稳定,且明显高于对照组(P <0. 05)。结论超声引导下床旁鼻空肠管置入术置管成功率高,置管时间短,并发症发生率低,适用于危重患者肠内营养。Objective To evaluate the application value of ultrasound-guided bedside nasal-jejunal catheterization in enteral nutrition of critically-ill patients.Methods Totally 112 critically-ill patients were randomly divided into control group(n=56,blind placement of nasointestinal feeding by gastric gas injection)and observation group(n=56,ultrasound-guided bedside nasal-jejunal feeding).The success rate of catheterization,incidence of complications and levels of nutritive indexes were compared between two groups.Results The success rate of catheterization once in observation group was higher than that in control group(87.50% vs.71.43%,P<0.05).The observation group was superior to control group regarding the time of tube to pass pylorus and reach the stomach,total catheterization time,time to achieve the target nutritional value and catheterization cost(P<0.05).The incidences of tube misplacement was lower than that in control group(P<0.05).Seven days after placement,the body mass index(BMI)and levels of nutritive indexes in control group went down markedly when compared with pre-placement(P<0.05).However,both BMI and levels of nutritive indexes in observation group were relatively stable,and were higher than those in control group(P<0.05).Conclusion Ultrasound-guided bedside nasal-jejunal catheterization is characterized by high success rate and short time of catheterization as well as low incidence of complications,suitable for the enteral nutrition in critically-ill patients.

关 键 词：危重患者 肠内营养 鼻空肠管置入术 超声 置管率 

分 类 号：R473.6[医药卫生—护理学]