腹部轨迹听诊法在机械通气患者床旁鼻肠管放置中的应用  

Application of abdominal trajectory auscultation in bedside naso-intestinal tube placement in mechanically ventilated patients

作　　者：吕杨锦 代甫路 韦晓君[1] 吴登助 Lyu Yangjin;Dai Fulu;Wei Xiaojun;Wu Dengzhu(Department of Critical Care Medicine,Hangzhou Red Cross Hospital,Hangzhou 310000,China;Department of Severe Infection,Hangzhou Red Cross Hospital,Hangzhou 310000,China)

机构地区：[1]杭州市红十字会医院重症医学科,310000 [2]杭州市红十字会医院结核重症监护室,310000

出　　处：《中华临床营养杂志》2020年第3期182-186,共5页Chinese Journal of Clinical Nutrition

摘　　要：目的探讨腹部轨迹听诊法在机械通气患者床旁鼻肠管放置中的应用效果。方法选择2018年1月1日至9月30日收住重症医学科需经幽门后喂养患者,行床旁超声引导下放置鼻肠管。对超声显像不清的48例患者采用随机数字分组法进行分组。对照组采用常规听诊法,研究组采用腹部轨迹听诊法,将两组听诊结果与X线定位结果进行对照,一致者代表腹部听诊方法有效,并评价一次性置管成功率、置管耗时、置管过程中生命体征的变化及并发症的发生率。结果研究组一次性置管成功率为92%(22/24例),经二次调整总置管成功率达96%(23/24例);对照组一次性置管成功率为67%(16/24例),经二次调整总置管成功率达92%(22/24例);研究组平均置管耗时为(20.79±2.27)min,对照组为(36.35±2.59)min,两组比较差异有统计学意义(P<0.05);两组的一次性置管成功率、总置管成功率、置管过程中生命体征的变化差异无统计学意义(P>0.05)。结论腹部轨迹听诊法能明显缩短机械通气患者床旁鼻肠管放置时间,且能提高机械通气患者床旁鼻肠管放置一次性置管成功率,可在临床重症患者留置鼻肠管中推广应用。Objective To explore the application of abdominal trajectory auscultation in bedside naso-intestinal tube placement in mechanically ventilated patients.Methods Patients who need to be fed through the pylorus in the Department of Critical Care Medicine from January 1st to September 30th,2018 were selected and placed naso-intestinal tubes under bedside ultrasound guidance.A total of 48 patients with unclear ultrasound imaging were divided by random number table into control group receiving conventional auscultation and the study group receiving abdominal locus auscultation.The auscultation results of the two groups were compared with the X-ray localization results,and those who agreed represented that the abdominal auscultation method was effective,and the success rate of one-time catheterization,time-consuming catheterization,changes in vital signs during catheterization and the incidence of complications were evaluated.Results The one-time catheterization success rate of the study group was 92%(22/24),and the total catheterization success rate reached 96%(23/24)after the second adjustment.The one-time catheterization success rate of the control group was 67%(16/24),and the total catheterization success rate reached 92%(22/24)after the second adjustment.The between the two groups was min in the research group and in the control group.The difference in average time spent on catheterization was statistically significant between the study group and the control group[(20.79±2.27)vs(36.35±2.59)min,P<0.05].There was no statistically significant difference in the one-time catheterization success rate,total catheterization success rate,and changes in vital signs during catheterization between the two groups(P>0.05).Conclusion Abdominal trajectory auscultation can significantly shorten the bedside naso-intestinal tube placement time of mechanically ventilated patients,and increase the success rate of one-time naso-intestinal tube placement at the bedside of mechanically ventilated patients,and can be popularized and appl

关 键 词：轨迹听诊法 鼻肠管 肠内营养 

分 类 号：R459.7[医药卫生—急诊医学]