实时超声辅助联合间断注水注气法在危重病人鼻空肠管留置中的应用  

Real-time ultrasound-assisted combined with intermittent water and gas injection in nasojejunal tube insertion in critically ill patients

作　　者：孙博睿[1] 张春[2,3] 申存毅[2,3] 金玉峰[2,3] 苏娇[2,3] 张靖垚 王铮 刘昌 SUN Bo-rui;ZHANG Chun;SHEN Cun-yi;JIN Yu-feng;SU Jiao;Zhang Jing-yao;WANG Zheng;LIU Chang(Department of Anesthesiology;Department of Surgical Intensive Care Unit;Department of Hepatobiliary Surgery,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,Shaanxi,China)

机构地区：[1]西安交通大学第一附属医院麻醉科,陕西西安710061 [2]西安交通大学第一附属医院外科ICU,陕西西安710061 [3]西安交通大学第一附属医院肝胆外科,陕西西安710061

出　　处：《肠外与肠内营养》2020年第4期199-204,共6页Parenteral & Enteral Nutrition

基　　金：国家自然科学基金(81601672)。

摘　　要：目的:评价床旁实时超声辅助联合间断注水注气法在危重病人鼻空肠管留置中的临床效果。方法:选择2017年7月1日至2019年4月30日西安交通大学第一附属医院外科ICU需要进行肠内营养管留置的危重病人进行回顾性分析,根据留置方式分为试验组及对照组,试验组采用实时超声辅助联合间断注水注气留置法,对照组采用徒手盲插留置法。比较两组操作时间、成功率及并发症情况。结果:共计50例病人纳入研究,其中试验组25例,对照组25例。试验组在操作时间上差异无统计学意义[(23.82±8.91)vs(22.35±7.62)min,P=0.538];试验组一次置管成功率显著优于对照组(92%vs 64%,P=0.037);两组病人操作过程中均未出现明显并发症。结论:床旁实时超声辅助联合间断注水注气法在危重病人鼻空肠管留置应用中具有安全可行的特点,值得临床广泛开展。Objective:To evaluate the efficiency of bedside real-time ultrasound-assisted combined with intermittent water and gas injection in nasojejunal tube insertion in critically ill patients.Methods:Between July 12017 to April 302019,patients who needed nutritional support through a jejunal feeding tube in the department of Surgical Care Unit from the first affiliated hospital of Xi’an Jiaotong university were recruited for this study.According to the different procedure,patients were divided into experimental group and control group.Real-time ultrasound assisted combined intermittent water injection gas injection was selected for the experimental group and traditional method was selected for the control group.Operating time,one-time success rate and complications were compared between the two groups.Results:A total of 50 patients were included in the study,25 in the experimental group and 25 in the control group.The operating time in the experimental group was longer than in the control group[(23.82±8.91)vs(22.35±7.62)min,P=0.538],but the difference was not significant.One-time success rate in the experimental group was significantly higher than in the control group(92%vs 64%,P=0.037).No obvious complications were discovered in all patients.Conclusion:Real-time bedside ultrasound assisted intermittent water injection in nasojejunal tube insertion is a safe and feasible method in critically ill patients.

关 键 词：危重病人 超声 鼻空肠管 

分 类 号：R459.3[医药卫生—治疗学]