注气法置胃肠双腔管在腹腔高压机械通气患者中应用.docVIP

注气法置胃肠双腔管在腹腔高压机械通气患者中应用 　　DOI：10.3760/cma.j.issn.1671-0282.2014.06.014 　　基金项目：卫生部国家临床重点专科项目（2011873）；天津市卫生系统新技术填补空白项目（2010008） 　　作者单位：300192 天津，天津市第一中心医院 ICU 　　通信作者：王勇强，Email：yongqiangwang1962@ 　　【摘要】目的 探讨注气法留置鼻胃肠双腔管在腹腔高压机械通气患者营养支持中的应用效果。方法 采用前瞻性纳入腹腔高压机械通气患者20例，随机分为对照组和观察组，每组10例，对照组采用留置胃管进行胃肠减压，运用胃内注气法留置鼻肠管进行肠内营养支持；观察组运用胃内注气法留置鼻胃肠双腔管进行胃肠减压和肠内营养支持，比较2组置管时间、置管前后腹内压变化、置管注气量、一次置管成功率、置管操作对患者疼痛影响评分、停止胃肠减压时间、肠内营养开始时间和机械通气时间。结果 观察组置管时间、置管注气量低于对照组，差异具有统计学意义（P0.05）；腹腔高压缓解时间、肠内营养开始时间、机械通气时间，差异无统计学意义（P0.05）。结论 胃内注气法留置鼻肠管成功率高，安全可靠，对腹腔高压机械通气患者留置鼻胃肠双腔管较同时留置鼻胃管和鼻肠管可改善患者舒适性，缩短置管时间，减少置管注气量。 　　【关键词】鼻胃肠双腔管；鼻肠管；注气法；腹腔高压；肠内营养；机械通气； 返流与误吸；营养途径 　　Application of dual lumen gastrointestinal tube with air insufflation technique in mechanical ventilation patients with intra-abdominal hypertension Wang Ying， Wang Yongqiang，Jiao Yanan，Ma Jie，Yang Yan.Departement of ICU， Tianjin First Center Hospital，Tianjin 300192，China 　　Corresponding author： Wang Yongqiang，Email：yongqiangwang1962@ 　　【Abstract】Objective To investigate the application effect of nasal gastrointestinal double lumen catheter tube placement with air insufflation in mechanically ventilated patients with intra-abdominal hypertension. Methods A total of 20 patients with intra-abdominal hypertension were randomly divided into control group and observation group （n=10 in each group） . Patients in control group received indwelling nasogastric tube for decompression and indwelling nasal intestine tube by air insufflation for enteral nutrition support . Patients in observation group received the dual lumen gastrointestinal tube for decompression and enteral nutrition support. The time required for catheterization， changes in intra-abdominal pressure before and after air insufflation， catheter success rate at one attempt， pain scores of patients to catheter operation， duration of decompression， enteral nutrition start time and the duration of mechanical ventilation were compared between two groups. Results The time required for catheterizat