呼气末二氧化碳分压监测在脑卒中吞咽障碍患者留置胃管中的应用  

Application of end-tidal carbon dioxide partial pressure monitoring in indwelling gastric tubes in stroke patients with swallowing disorders

作　　者：李红霞[1] 夏泽燕 朱艳萍[1] 惠晓芳[1] 蔡雪[1] 毛进[1] 夏如翠 LI Hongxia;XIA Zeyan;ZHU Yanping;HUI Xiaofang;CAI Xue;MAO Jin;XIA Rucui(Zhongda Hospital Affiliated to Southeast University,Nanjing,210009,China)

机构地区：[1]东南大学附属中大医院,江苏省南京市210009

出　　处：《护理实践与研究》2023年第18期2774-2778,共5页Nursing Practice and Research

基　　金：东南大学附属中大医院护理科研基金资助项目(编号:KJZC-HL-202106)。

摘　　要：目的 观察呼气末二氧化碳分压(PetCO_(2))监测在脑卒中吞咽障碍患者留置胃管中的应用效果。方法 选择2022年1—9月在东南大学附属中大医院急诊科就诊的210例脑卒中吞咽障碍患者为研究对象,按照组间基本资料具有可比性的原则分为对照组和观察组,各105例。对照组采用传统盲插法进行胃管留置,观察组在PetCO_(2)监测下进行胃管留置。比较两组患者的置管用时、一次性置管成功率、不良反应发生率、胃管在位准确率及生命体征波动变化情况。结果 210例患者均完成留置胃管操作。观察组留置胃管用时低于对照组(P<0.05);观察组一次性置管成功率高于对照组(P<0.05);观察组患者恶心/呕吐、呛咳、黏膜出血发生率低于对照组(P<0.05)。两组患者胃管在位准确率比较差异无统计学意义(P>0.05)。观察组患者在留置胃管过程中呼吸、心率、血氧饱和度、血压的变化波动值低于对照组,差异有统计学意义(P<0.05)。结论 脑卒中吞咽障碍患者在PetCO_(2)监测下置入胃管,能够指导护士准确判断胃管位置,提高一次性置管成功率,缩短置管用时,减少不良反应,维持患者生命体征稳定,保证患者安全。Objective To observe the application effect of end-tidal carbon dioxide partial pressure(PetCO2)monitoring in indwelling gastric tubes in stroke patients with swallowing disorders.Methods To select 210 patients with stroke swallowing disorders who visited the emergency department of Zhongda Hospital Affiliated to Southeast University from January to September 2022 as the research subjects,they were divided into a control group and an observation group based on the principle of comparability of basic data between groups,with 105 patients in each group.The control group used traditional blind insertion method for gastric tube indwelling,while the observation group used PetCO2 monitoring for gastric tube indwelling to compare the duration of catheterization,success rate of one-time catheterization,incidence of adverse reactions,accuracy of gastric tube placement,and changes in vital signs between two groups of patients.Results All 210 patients completed the indwelling gastric tube operation.The duration of indwelling gastric tubes in the observation group was lower than that in the control group(P<0.05).The success rate of one-time catheterization in the observation group was higher than that in the control group(P<0.05).The incidence of nausea/vomiting,coughing,and mucosal bleeding in the observation group was lower than that in the control group(P<0.05).There was no statistically significant difference in the accuracy rate of gastric tube placement between the two groups(P>0.05).The fl uctuation values of respiration,heart rate,blood oxygen saturation,and blood pressure during the indwelling of gastric tubes in the observation group were lower than those in the control group,and the diff erences were statistically signifi cant(P<0.05).Conclusion Placing a gastric tube under PetCO2 monitoring in stroke patients with swallowing disorders can guide nurses to accurately determine the position of the gastric tube,improve the success rate of one-time catheterization,shorten the catheterization time,reduce adverse reacti

关 键 词：呼气末二氧化碳分压 监测 脑卒中 吞咽障碍 留置胃管 

分 类 号：R472[医药卫生—护理学]