危重症患者内镜引导下可视化鼻肠管置管方法及效果  

Method and effects of endoscope-guided visualized placement of nasoenteral feeding tubes in critically ill patients

作　　者：刘晓玲 刘恩红 王雪纯 孙亮 曾雅妮 白怡 贾珊珊 郑艳 Liu Xiaoling;Liu Enhong;Wang Xuechun;Sun Liang;Zeng Yani;Bai Yi;Jia Shanshan;Zheng Yan(Nursing Department,The Sixth Hospital of Wuhan,Affiliated Hospital of Jianghan University,Wuhan 430015,China)

机构地区：[1]江汉大学附属医院武汉市第六医院护理部,湖北武汉430015 [2]江汉大学附属医院武汉市第六医院呼吸与危重症医学科,湖北武汉430015 [3]江汉大学附属医院武汉市第六医院重症医学科,湖北武汉430015 [4]江汉大学附属医院武汉市第六医院康复医学科,湖北武汉430015 [5]江汉大学附属医院武汉市第六医院神经内科,湖北武汉430015 [6]江汉大学附属医院武汉市第六医院肿瘤科,湖北武汉430015

出　　处：《护理学杂志》2024年第7期73-76,共4页Journal of Nursing Science

摘　　要：目的探索内镜引导下可视化鼻肠管置管在危重症患者中的应用效果。方法将100例危重症患者按鼻肠管置管时间分为对照组和观察组各50例。对照组采用床旁盲插置入鼻肠管,观察组采用内镜引导下可视化置入鼻肠管。结果观察组首次置管成功率显著高于对照组,置管耗时显著短于对照组,置管过程中患者平均动脉压、心率、血氧饱和度波动显著小于对照组(均P<0.05),观察组患者大便潜血、鼻腔黏膜出血及渗血、误入气道发生率显著低于对照组(均P<0.05)。结论内镜引导下可视化鼻肠管置管可提高患者首次置管成功率,缩短置管时间,减少置管过程中患者血压、心率和血氧饱和度变化,降低置管并发症发生率。Objective To explore the application effect of endoscope-guided visualized placement of nasoenteral feeding tubes in critically ill patients.Methods A total of 100 critically ill patients undergoing placement of nasoenteral feeding tubes were divided into a control group and an experimental group chronologically,with 50 patients in each group.The control group were placed nasoenteral feeding tubes utilizing bedside blind placement,while the experimental group used endoscope-guided visualized placement.Results The first-attempt success rate of tube placement in the experimental group was significantly higher than that in the control group,its duration of tube placement was significantly shorter,and its fluctuations of average arterial pressure,heart rate,and oxygen saturation during the tube placement were significantly less than those in the control group(all P<0.05).And the incidences of fecal occult blood,nasal mucosa bleeding,nasal mucosa oozing,and accidental tracheal entry in the experimental group were significantly lower than those in the control group(all P<0.05).Conclusion Endoscope-guided visualized placement of nasoenteral fee-ding tubes can increase the first-attempt success rate,shorten the duration of tube placement,reduce the fluctuations in average arterial pressure,heart rate,and oxygen saturation during the placement process,and decrease the incidence of complications related to tube placement.

关 键 词：危重症患者 肠内营养 鼻肠管 内镜 可视化置管 内镜图谱 大便潜血 鼻腔黏膜出血 

分 类 号：R471[医药卫生—护理学]