磁导航指导鼻肠管置管在重症急性胰腺炎患者中的实施效果  

Implementation effect of magnetic navigation for guiding nasointestinal catheterization in patients with severe acute pancreatitis

作　　者：吴雷[1] 彭艳[2] WU Lei;PENG Yan(ICU,Youyang Hospital,First Affiliated Hospital of Chongqing Medical University,Chongqing 409800,China;Surgical ICU,First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院酉阳医院ICU,重庆409800 [2]重庆医科大学附属第一医院重症医学外科ICU,重庆400016

出　　处：《现代医药卫生》2019年第24期3784-3787,共4页Journal of Modern Medicine & Health

摘　　要：目的探讨磁导航指导鼻肠管置管在重症急性胰腺炎(SAP)患者中的效果与可行性。方法将2017年1月至2018年6月重庆医科大学附属第一医院外科ICU收治的90例SAP患者采用随机数字表法分为对照组和观察组,每组45例。观察组采用磁导航指导鼻肠管置管,对照组采用床旁徒手盲插法置入鼻肠管技术。比较2组患者置管时间及成功率、并发症发生状况、导管保留时间、营养指标、患者满意度等。结果观察组患者置管时间短于对照组,大便隐血阳性率、平均动脉压、腹内压均明显低于对照组,置管成功率、患者满意度均明显高于对照组,差异均有统计学意义(P<0.05);2组患者导管保留时间、导管堵管率、营养相关指标比较,差异均无统计学意义(P>0.05)。结论采用磁导航指导鼻肠管置管为SAP患者床旁留置鼻空肠营养管操作时间短、并发症少、成功率高,值得推广使用。Objective To investigate the effect and feasibility of magnetic navigation for guiding the nasointestinal catheterization in the patients with severe acute pancreatitis(SAP).Methods A total of 90 patients with SAP in the surgical ICU of the First Affiliated Hospital of Chongqing Medical University from January 2017 to June 2018 were divided into the control group and observation group by adopting the random number table method,45 cases in each group.The observation group adopted the magnetic navigation to guide the nasointestinal catheterization,while the control group adopted the bedside manual blind insertion.The catheterization time,success rate,complications occurrence status,catheter retention time,nutrition indexes and patient satisfaction were compared between the two groups.Results The catheterization time,positive rate of fecal occult blood,average arterial pressure and intra-abdominal pressure in the observation group were significantly lower than those in the control group,while the catheterization success rate and patient satisfaction were higher than those in the control group with the statistically significant difference(P<0.05).However,there were no statistically significant differences in the catheter retention time,catheter plugging rates and nutrition-related indicators between the two group(P>0.05).Conclusion Adopting the magnetic navigation for guiding the nasointestinal catheterization in the patients with SAP has short operation time,less complications and high success rate than the bedside indwelling nasojejunal nutrition tube,which is worth promoting and applying.

关 键 词：危重病 急性病 胰腺炎 肠道营养 磁导航 鼻肠管 

分 类 号：R657.51[医药卫生—外科学] R459.3[医药卫生—临床医学]