[1]赵秋菊,郝利,方淋,等.胃管自带导丝在同侧鼻腔更换留置胃管中的应用[J].第三军医大学学报,2017,39(15):1590-1593.
 ZHAO Qiuju,HAO Li,FANG Lin,et al.Application of guide wire in replacement of gastric tube in ipsilateral nasal cavity for critically ill neurological patients[J].J Third Mil Med Univ,2017,39(15):1590-1593.
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
39卷
期数:
2017年第15期
页码:
1590-1593
栏目:
临床医学
出版日期:
2017-08-15

文章信息/Info

Title:
Application of guide wire in replacement of gastric tube in ipsilateral nasal cavity for critically ill neurological patients
作者:
赵秋菊郝利方淋王英
第三军医大学大坪医院野战外科研究所神经内科
Author(s):
ZHAO Qiuju HAO Li FANG Lin WANG Ying

Department of Neurology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China

关键词:
留置胃管神经危重症患者更换导丝
Keywords:
indwelling gastric tube' target="_blank" rel="external">">indwelling gastric tube critically ill neurological patients replacement guide wire
分类号:
R472.91; R741.05
文献标志码:
A
摘要:
目的     探讨一种利用胃管自带导丝引导更换神经危重症患者同侧鼻腔留置胃管的方法与效果。方法      选择2016年1月至2016年12月100例在大坪医院神经内科需更换胃管的神经危重症患者,按随机数表法分为观察组52例,对照组48例。对照组采用常规方法更换胃管;观察组将新胃管导丝尾端接头剪掉,原胃管在距鼻腔外5 cm处剪断,利用导丝交换技术置入新胃管,即通过原胃管途径置入导丝,再将新胃管通过导丝置入原位置。比较两组患者的一次性置管成功情况、操作时间以及对更换胃管刺激的反应程度。结果      观察组一次性置管成功率(92.3%)高于对照组(46.6%),操作时间观察组(9.87±1.91) min远低于对照组(23.23±4.58)min、观察组收缩压、心率、呼吸波动范围[(14.33±4.19) mmHg、(16.91±6.23)次/min、(3.3±1.59)次/min]低于对照组[(24.10±5.26)mmHg、(26.33±8.74)次/min、(5.6±2.44)次/min],对更换胃管的刺激如恶心、呛咳、呕吐发生率(5.8%、11.5%、0)低于对照组(33.3%、47.9%、12.5%),差异有统计学意义(P<0.05)。结论     胃管自带导丝更换神经危重症患者同侧鼻腔留置胃管,操作简单,安全有效,不增加患者住院费用,可在临床推广应用。
Abstract:

Objective      To investigate the application of guide wire in the replacement of gastric tube in the ipsilateral nasal cavity for critically ill neurological patients and evaluate the efficacy.  Methods     A total of 100 severe patients who admitted our neurological department between January and December 2016 and needed feeding tube insertion were recruited in this study. They were randomly divided into observation (n=52) and control groups (n=48). In the former group, after the new gastric tube guide wire was cut at the end and the original gastric tube was also cut at 5 cm away from the nasal cavity, the new gastric tube was inserted by wire transfer technique (the new tube used the old one's guide wire). In control group, the new gastric tube was replaced by routine method. The success rate of one-time indwelling, operation time and severity of reaction to the replacement were observed and compared between the 2 groups. Results      Compared with the control group, the observation group had significantly higher success rate of one-time indwelling (92.3% vs 46.6%, P=0.001), shorter operation time (9.87±1.91 vs 23.23±4.58 min, P<0.001), and lower ranges of fluctuation in systolic blood pressure (14.33±4.19 vs 24.10±5.26 mmHg), heart rate (16.91±6.23 vs 26.33±8.74 times/min), and respiratory rate (3.3±1.59 vs 5.6±2.44 times/min). What’s more, the incidences of reactions to the replacement, such as nausea (5.8% vs 33.3%), irritating cough (11.5% vs 47.9%) and vomiting (0 vs 12.5%) were obviously lower in the observation group than the control group. Conclusion      Using guide wire to replace gastric tube in the ipsilateral nasal cavity is easy to operate, safe and efficient, and not to increase hospital cost. So it is worthy of promotion in clinical practice.

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更新日期/Last Update: 2017-08-14