早产儿经口置入胃管置管长度测量方法的改良及效果评价

目的 改良早产儿经口置入胃管置管长度的测量方法,并评价其效果。方法 选取北京市某三级甲等医院在新生儿中心实施经口置入胃管的306例早产儿作为研究对象。将2019年8月—2021年4月,经口置入胃管的155例早产儿作为试验组,胃管置管测量长度的方法为从患儿鼻尖到外耳廓中点2倍的距离;将2018年3月—2019年7月经口置入胃管的151例早产儿作为对照组,胃管置管测量长度的方法为从患儿鼻尖到耳垂到剑突的距离,比较两组胃管管端到位率、胃肠减压前3 d每日的引流量、呕吐发生率及胃肠减压总时间。结果 试验组经口置入胃管管端到位率为85.81%,对照组为15.23%,两组比较,差异具有统计学意义（χ²=152.44,P<0.001）;试验组胃肠减压前3 d引流量多于对照组,两组比较,差异具有统计学意义（t=14.38、t=15.78、t=11.06,均P<0.001）;试验组胃肠减压期间呕吐发生率为9.68%,低于对照组的20.58%,两组比较,差异具有统计学意义（χ²=7.05,P=0.008）;试验组胃肠减压时间为（6.90±3.57） d,短于对照组的（8.27±3.88） d,两组比较,差异具有统计学意义（t=12.74,P<0.001）。结论 采用改良的早产儿经口置入胃管置管长度测量方法,能有效提高胃管管端到达理想位置的精准度,避免胃管管端位置过浅或过深,并提高胃肠减压的效果。

Modification and effect evaluation of prediction of orogastric tube insertion length in premature infants

Objective To modify the insertion length of orogastric tube placement in premature infants and to evaluate its effect. Methods A total of 306 premature infants undergoing orogastric tube insertion in the Neonatal Center of a tertiary A hospital in Beijing were selected as the study subjects. 155 premature infants undergoing orogastric tube insertion from August 2019 to April 2021 were selected as the test group,and 151 premature infants from March 2018 to July 2019 were in the control group. The effects of different predicting methods on the correct placement rate of the orogastric tube tip,drainage volume before gastrointestinal decompression,number of vomiting episodes,and the total time of gastrointestinal decompression were compared in 2 groups. Results The correct placement rate of orogastric tube tip was 85.81% in the test group and 15.23% in the control group,and the difference was statistically significant（P<0.001）. The drainage volume 3 days before gastrointestinal decompression in the test group was higher than that in the control group,and the difference was statistically significant（t=14.38,t=15.78,t=11.06,all,P<0.001）. The incidence rate of vomiting during gastrointestinal decompression in the test group was lower than that in the control group（χ²=7.05）,and the difference was statistically significant（P=0.008）. The total time of gastrointestinal decompression was shorter than that in the control group（t=12.74）,and the difference was statistically significant（P<0.001）. Conclusion The modified method of predicting insertion length of orogastric tube in premature infants can improve the accuracy of optimal placement for the orogastric tube tip,avoid misplacement of the orogastric tube,and improve the effect of gastrointestinal decompression.