不同溶液用于鼻肠管肠内营养患者封管的效果评价  

Evaluation of the effect of different solutions for endoscopic nutrition in nasal and intestinal patients

作　　者：欧玉凤 赵慧华 许丽娜 Ou Yufeng;Zhao Huihua;Xu Lina(Thoracic Surgery Department,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Nursing,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院胸外科,上海200032 [2]复旦大学附属中山医院护理部,上海200032

出　　处：《中国实用护理杂志》2020年第9期646-650,共5页Chinese Journal of Practical Nursing

基　　金：复旦大学附属中山医院科研发展基金(2018ZSFZ047)。

摘　　要：目的比较不同溶液封管预防鼻肠管堵塞的应用效果。方法选取2018年6月至2019年5月留置鼻肠管行肠内营养治疗的患者199例。按照随机数字表法随机分为3组:温开水封管组67例,常温无糖可乐封管组67例,α-糜蛋白酶封管组65例。比较3种不同溶液封管后的鼻肠管堵塞率、不同肠内营养治疗周期(<7 d,7~29 d,≥30 d)中的鼻肠管堵塞率、导管通畅维持时间和堵塞后再通率以及并发症的发生率。结果温开水封管组与常温无糖可乐封管组相比较,导管堵塞率由20.9%(14/67)降至3.0%(2/67)(χ^2值为10.220),导管通畅维持时间由(8.83±1.84)d延长至(9.92±1.63)d(t值为2.034),导管堵塞后的再通率由21.4%(3/14)升至100.0%(χ^2值为5.021),差异有统计学意义(P<0.05);温开水封管组与α-糜蛋白酶封管组相比较,导管堵塞率由20.9%(14/67)降至4.6%(3/65)(χ^2值为8.152),导管通畅维持时间由(8.83±1.84)d延长至(10.06±1.45)d(t值为2.182),导管堵塞后的再通率由21.4%(3/14)升至100.0%(χ^2值为6.679),差异均有统计学意义(P<0.05);而常温无糖可乐封管组与α-糜蛋白酶封管组相比较,导管堵塞率、通畅维持时间、堵塞后再通率及并发症发生率差异均无统计学意义(P>0.05)。比较不同肠内营养治疗周期患者的导管堵塞率,<7 d的3组患者均为0,差异无统计学意义(P>0.05);7~29 d治疗周期患者的导管堵塞率分别为温开水封管组11.9%(8/67)、常温无糖可乐封管组1.5%(1/67)、α-糜蛋白酶封管组1.5%(1/65);≥30 d肠内营养治疗周期患者的导管堵塞率分别为温开水封管组9.0%(6/67)、常温无糖可乐封管组1.5%(1/67)、α-糜蛋白酶封管组3.1%(2/65),常温无糖可乐封管组与α-糜蛋白酶封管组明显优于温开水封管组,且差异有统计学意义(χ^2值为5.836、4.414和5.836、4.325,P<0.05),常温无糖可乐封管组与α-糜蛋白酶封管组之间差异无统计学意义(P>0.05)。结论无糖可乐和α-糜蛋白酶替代温开�Objective To investigate the effect of different solutions to prevent nasal intestinal blockage.Methods Tottaly 199 cases of enteral nutrition treatment were selected from June 2018 to May 2019 and were randomly divided into three groups:warm boiled water group(67 cases),sugar-free cola group(67 cases),alpha-chymotrypsin group(65 cases).The rate of nasointestinal obstruction,the rate of nasointestinal obstruction,the rate of catheter patency maintenance,the rate of recanalization and the incidence of complications in three different enteral nutrition treatment cycles(<7 days,7-29 days,≥30 days)were compared.Results The catheter blockage rate in warm boiled water group was 20.9%(14/67)and in sugar-free cola group was 3.0%(2/67).The patency maintenance time in warm boiled water group was(8.83±1.84)days and in sugar-free cola group was(9.92±1.63)days(t value was 2.182).The recanalization rate after blockage in warm boiled water group was 21.4%(3/14)and in sugar-free cola group was 100.0%(χ^2 value was 5.021,P<0.05).The catheter blockage rate in sugar-free cola group was significantly lower than that in warm boiled water group,the catheter maintenance time and recanalization rate after blockage were significantly higher than that in warm boiled water group,the difference was significant(P<0.05).There was no significant difference between sugar-free cola group and alpha-chymotrypsin group in catheter blockage rate,catheter blockage rate,recanalization rate after blockage and incidence of complications(P>0.05).The catheter blockage rate was 0 in patients with enteral nutrition treatment cycle<7 days.The catheter blockage rate was 11.9%(8/67)(warm boiled water group),1.5%(8/67)(sugar-free cola group)and 1.5%(8/67)(alpha-chymotrypsin group)in patients with enteral nutrition treatment cycle 7-29 days.The catheter blockage rate was 9.0%(6/67)(warm boiled water group),1.5%(1/65,sugar-free cola group)and 3.1%(2/67)(alpha-chymotrypsin group)in patients with enteral nutrition treatment cycle>30 days.The catheter blockage

关 键 词：鼻肠管 堵塞 封管 无糖可乐 Α-糜蛋白酶 

分 类 号：R45[医药卫生—治疗学]