螺旋型鼻肠管双导丝置管方法在ICU临床应用研究

目的探索ICU病房内对危重患者应用双导丝法和主动置管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将163例危重住院患者分别采用双导丝法(n=87)和主动置管法(n=76)行床边盲插鼻肠喂养管,观察2种置管方法的成功率、重要生命体征的变化及呼吸道内置管或消化道穿孔等并发症发生情况。结果双导丝法和主动置管法的置管成功率分别为94.25%和71.05%,差异有非常显著性(P<0.01);2种置管方法患者重要生命体征无明显变化,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,双导丝法与主动置管法相比,是技术上更易掌握、成功率更高且有着同样安全性的置管法。

Clinical application of placement of nasoenteral feeding tubes by double guidewire method

Objective To investigate success rate and safety of bedside blind placement of nasoenteral feeding tubes by double guidewire method or active tube indwelling method applied to critical patients in ICU. Method 163 critical patients randomly received blindly placed bedside nasoenteral feeding tubes by double guidewire method （ n = 87） or active tube in- dwelling method （ n = 76） respectively. The success rate, changes of important vital signs, complications of built-in tube in re- spiratory tract and digestive tract perforation of the two methods were closely observed. Results The success rates of the two methods were respectively 94.25% and 71.05%. There was significant difference（P 〈 0.01 }. There were no apparent changes of important vital signs. No complications occurred in terms of built-in tube in respiratory tract and digestive tract perforation. Conclusion In comparison of the two methods,the double guidewire method is easier to manipulate with higher rate of success and safety.