集束化策略在提高机械通气患者床旁盲插鼻空肠管成功率中的应用  

Application of bundle strategy in improving the success rate of bedside blind intubation of naso-jejunal tube in patients with mechanical ventilation

作　　者：彭莉芳[1] 王全根 王晓燕 PENG Lifang;WANG Quan'gen;WANG Xiaoyan(ICU,Ji'an Central People's Hospital in Jiangxi Province,Ji'an 343000,China;Medical Department,Jing'gangshan University,Ji'an 343000,China)

机构地区：[1]江西省吉安市中心人民医院ICU,江西吉安343000 [2]井冈山大学医学部,江西吉安343000

出　　处：《中国现代医生》2020年第34期170-173,共4页China Modern Doctor

基　　金：江西省吉安市指导性科技计划项目[吉市科计字〔2019〕8号(16)]。

摘　　要：目的探讨集束化策略在提高机械通气患者床旁盲插鼻空肠管成功率中的应用价值。方法选择2017年1月~2019年12月重症加强护理病房(ICU)机械通气存在高度误吸风险和经胃肠内营养不耐受的80例患者为观察对象,随机分为实验组(采用集束化策略)和对照组(采用常规置管方法),每组各40例。对比分析两组患者的一次性置管成功率、置管期间的并发症、置管所需时间和患者营养状况改善情况。结果实验组患者一次性置管成功率达到95.0%,而并发症总发生率仅为2.5%,明显优于对照组的60.0%和15.0%,同时,实验组置管所需时间明显短于对照组(P<0.05)。肠内营养治疗1周后,实验组血清总蛋白、血清清蛋白、血红蛋白水平明显高于对照组(P<0.05)。结论在机械通气患者床旁盲插鼻空肠管过程中应用集束化护理策略,有助于改善插管效果和营养供给状况,保证置管的成功率,降低相关并发症的发生率。Objective To investigate the application value of bundle strategy in improving the success rate of bedside blind intubation of naso-jejunal tube in patients with mechanical ventilation.Methods In this research,80 patients in Intensive Care Unit(ICU)from January 2017 to December 2019 with high risk of aspiration and intra-gastrointestinal nutritional intolerance during mechanical ventilation were selected as the observation objects,and randomly divided into the experimental group(bundle strategy was applied)and the control group(conventional catheter placement method was applied),with 40 cases in each group.The one-time success rate of intubation,total complications during intubation,the time required for intubation and the improvement of patients'nutritional status were compared and analyzed between the two groups of patients.Results The one-time success rate of intubation in the experimental group was 95.0%,while the incidence of complications was only 2.5%,which were significantly better than those of 60.0%and 15.0%in the control group,respectively.At the same time,the time required for intubation in the experimental group was significantly shorter than that in the control group(P<0.05).After one week of enteral nutrition therapy,the levels of serum total protein,serum albumin and hemoglobin in the experimental group were significantly higher than those in the control group(P<0.05).Conclusion The application of bundle nursing strategy in bedside blind intubation of naso-jejunal tube in patients with mechanical ventilation is helpful to improve the intubation efficacy and nutrition supply condition,ensure the success rate of intubation and reduce the incidence of related complications.

关 键 词：集束化策略 机械通气 床旁盲插鼻空肠管 一次性置管成功率 

分 类 号：R473[医药卫生—护理学]