重型颅脑损伤肠内营养患者双导丝鼻胃管置入空肠方法的改进

目的提高重型颅脑损伤患者鼻胃管置入空肠的有效率和安全性。方法按时间顺序将264例重型颅脑损伤患者分为对照组109例、观察组155例。对照组采用单导丝鼻胃管盲插置入空肠;观察组采用改进法即单导丝鼻胃管入胃内后再放入第2根导丝,盲插通过幽门后抽出第2根导丝,再用单导丝鼻胃管送入至85~95cm,结束送管。结果两组置入成功率分别为92.7%和94.2%,差异无统计学意义(P0.05);观察组置管耗时显著短于对照组(P0.01);两组均未发生心律失常、消化道出血或穿孔等置管并发症,均未出现堵管现象。结论对重型颅脑损伤肠内营养患者采用改进法双导丝鼻胃管置入空肠,有利于提高置管效率,保障患者安全。

Double-guidewire technique for naso-gastric-jejunal feeding tube placement in traumatic brain injury patients

Objective To enhance the effectiveness and safety of naso-gastric-jejunal feeding tube placement in traumatic brain injury patients.Methods A total of 264 patients with traumatic brain injury were divided into a control group of 109 and an observation group of 155 according to admission time.The control group received naso-gastric-jejunal feeding tube placement using single-guidewire technique,while the observation group received naso-gastric-jejunal feeding tube placement using double-guidewire technique:the second guidewire was inserted after placement of the feeding tube into the stomach and then removed when the tube was advanced blindly over the pylorus,then the tube was continued to be inserted further to the jejunum with a depth of 85-95 cm.Results The rate of success insertion was 92.7 ％ in the control group and 94.2 ％ in the observation group,with no statistically sig nificant difference between the two groups (P＞0.05),whilst the time of completion of the insertion was significantly shorter in the observation group than the control group (P＜0.01).Both groups did not develop complications as arrythmia,bleeding and perforation during insertion,and had no tube obstruction.Conclusion Double guidewire technique for placement of naso-gastric-je junal feeding tube in patients with traumatic brain injury can improve work efficiency and ensure patient safety.