床边盲插鼻肠喂养管两种置管方法的比较.docVIP

床边盲插鼻肠喂养管两种置管方法的比较 蓝惠兰　钟华荪　黄碧灵　赵绥民 (广东省人民医院危重病监护中心,广东广州510100) 　　摘　要　目的比较初学操作者用多导丝法和螺旋推进法行床边盲插鼻肠喂养管的成功率和安全性。方法同 一初学操作者随机为40 例危重住院患者用多导丝法和螺旋推进法行床边盲插鼻肠喂养管各20 例。结果多导丝 法和螺旋推进法的置管成功率分别为90 %和35 % ,差异有显著意义( P 0. 01) ,两组患者均无呼吸道内置管或消化 道穿孔等并发症。结论对于初学床边盲插鼻肠喂养管操作者,多导丝法与螺旋推进法相比,是技术上更易掌握、成 功率更高的安全置管法。 关键词　危重病　　肠营养　　吸入性肺炎　　鼻肠管　　管饲 Comparison of two technique of tube placement for bedside blind placement of nasal- intestinal feeding tube Lan Huilan 　Zhong Huasun 　Huang Biling ,et al (Monitoring center for critical ill patients , Provincial people?s hospital of Guangdong , Guangzhou 510000) Abstract Objective To compare the success rate and safety of the multi - style technique vs that of the corkscrew technique used by new learner for bedside blind placement of nasal - intestinal feeding tubes.Methods Forty nasal intestinal feeding tubes were introduced blindly at the bedside using either the multi - style technique or corkscrew technique by the same learner in 2 groups of patients ,each group consists of 20 critically ill patients. Result The success rate of tube placement was 90 % and 35 % for group using multi - style technique and corkscrew technique respectively. There was significantly difference between the two groups( P 0101) . No inadvertent Respiratory placement of feeding tubes or perforation of the GI track occurred in both group. Conclusion Foe bedside blind placement of nasal intestinal feeding tubes by new learner ,the multi - style technique is more effi2 cient compared with the corkscrew technique ,and with a higher success rate. Key words 　Critical ill 　　Intestinal nutrition 　　Aspiration pneumonia 　　Nasal - intestinal tube 　　Tube feeding 中图分类号:R472. 9 　　文献标识码:A 　　文章编号:100226975 (2003) 0320207203 　　作者简介: 蓝惠兰(1965 —) ,女,广东河源,大学,主管护 师,研究方向:危重病临床护理 　　许多危重患者存在不同程度的胃动力紊乱,经 鼻胃管管饲容易发生胃食管反流和吸入性肺炎。经 鼻肠管管饲是非常重要的营养支持手段,床边盲插 鼻肠管是常用的置管方法,但成功置入鼻肠管并不 容易。大多数置管方法为被动等待管端由胃腔自动 通过幽门移行至十二指肠或空肠上段,成功率较低。 由手法操作直接将喂养管管端通过幽门插至十二指 肠或空肠上段的主动置管法,文献报道不多。Zalo2 ga[1 ] 报道的螺旋推进置管法成功率达95 %。Nich