超声引导联合腹部四分区触诊法在鼻肠管放置中的应用研究  

Application of ultrasound combined with abdominal palpation in nasojejunal feeding tube placement

作　　者：孙建华 李欣 赵明曦 马鸿鸣 崔文博 刘莹 罗红波 李尊柱 张青 张宏民 王小亭 重症超声研究组 SUN Jianhua;LI Xin;ZHAO Mingxi;MA Hongmin;CUI Wenbo;LIU Ying;LUO Hongbo;LI Zunzhu;ZHANG Qing;ZHANG Hongming;WANG Xiaoting;Critical Care Ultrasound Study Group(CCUSG)(Department of Critical Care Medicine,Chinese Academy of Medical Sciences,Peking Union Medical College,Peking Union Medical College Hospital,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院重症医学科,北京100730

出　　处：《护士进修杂志》2022年第20期1834-1837,1856,共5页Journal of Nurses Training

基　　金：北京市科技计划项目(编号:Z201100005520038);中央高校基本科研业务费专项资金项目(编号:333202101B)。

摘　　要：目的探讨超声引导联合腹部四分区触诊法在鼻肠管放置中的应用效果。方法采用非同期临床对照研究,运用目标抽样法选取2018年6月-2019年7月纳入的67例患者作为对照组,2019年9月-2020年12月纳入的66例患者作为观察组。对照组采用超声引导联合胃窦渐进式注水法放置鼻肠管;观察组在对照组基础上,引入腹部四分区触诊法。比较2组患者在置管成功率、置管时间、营养达标率、目标热量达标时间及置管48 h内并发症发生情况的差异。结果观察组患者置管成功率和目标热量达标时间均优于对照组(P<0.05);2组患者置管时间、营养达标率及置管48 h内并发症差异均无统计学意义(P>0.05)。结论超声引导联合腹部四分区触诊法可明确鼻肠管尖端位置,有助于重症患者床旁动态引导鼻肠管置入,提高鼻肠管放置的成功率,促进患者早期快速达到目标营养量。Objective To explore the application effect of ultrasound guidance combined with abdominal four-zone palpation in nasointestinal tube placement.Methods A non-contemporaneous controlled clinical study was conducted.A total of 67 patients enrolled from June 2018 to July 2019 were selected as the control group,and 66 patients enrolled from September 2019 to December 2020 were selected as the observation group.The nasointestinal tube in the control group was placed by ultrasound guidance combined with progressive water injection in the gastric antrum.On the basis of the control group,the abdominal four-zone palpation was introduced in the observation group.The success rate of catheterization,catheterization time,standard-reaching rate of nutrition,target heat standard time,and the incidence of complications within 48 h of catheterization were compared between 2 groups.Results The success rate of catheterization and target heat standard time in observation group were better than those in control group(P<0.05).There were no significant differences in catheterization time,standard-reaching rate of nutrition,and the incidence of complications within 48 h between 2 groups(P>0.05).Conclusions Ultrasound combined with abdominal palpation protocol can identify the tip of the nasojejunal feeding tube,which is helpful for bedside dynamic guidance of nasointestinal tube placement in critically ill patients,and can improve the success rate of the nasojejunal feeding tube and promote the early rapid progress of the patient to achieve the target nutrition.

关 键 词：超声检查 触诊 鼻肠管 重症患者 重症监护 

分 类 号：R473.5[医药卫生—护理学] R459.3[医药卫生—临床医学]