全麻下儿童经胃镜空肠管置管成功的影响因素分析

目的探讨影响全麻下儿童经胃镜空肠管置管成功的因素。方法选取2017年2月—2019年12月于医院行全麻手术并辅以经胃镜空肠管置管的患儿26例作为研究对象,将其中一次置管成功的10例患儿作为成功组,置管次数≥2次的16例患儿作为对照组。调查分析影响经胃镜空肠管置管成功的因素。结果单因素及多因素Logistic回归分析结果显示,影响全麻患儿胃镜引导下空肠管置管成功的危险因素为年龄、胃食管反流、胃排空延迟、胃动力不足、反复性置管、导丝位置无法完全掌握、退出胃镜致导丝位置移动、与屈氏韧带的距离(≥40 cm或≤15 cm)(P<0.05)。结论影响全麻患儿胃镜引导下空肠管置管成功的危险因素诸多,其中导丝位置移动、胃动力不足是置管中常见原因,因此在置管前需预先分析,并辅以相应的护理配合措施,以此提升空肠管置管成功率,促使能一次性成功。

Influencing factors ana lysis of the success of gastrointestinal catheterization in children under general anesthesia

Objective To explore the factors influencing the success of gastrointestinal catheterization in children under general anesthesia.Methods To select 26 general anesthesia combined with transgastrostomal jejunal tube feeding children admitted in the hospital from February 2017 to December 2019 were selected as the study objects,10 children who place the tube successfully for one-time were set as the success group,16 children who place the tube up to two times were set as the control group.To explore and analysis the influencing factors of the successful gastrointestinal catheterization.Results Univariate analysis showed that,age,gastroesophageal reflux,gastric emptying delay,gastric insufficiency,unstable guide wire position,gastroscope exit caused guide wire position changed,distance to the torsion ligament were the influencing factors of one-time success tube catheterization(P<0.05).Multivariate Logistic regression analysis showed that,the factors influencing the success of gastrointestinal catheterization in children under general anesthesia were age,gastroesophageal reflux,gastric emptying delay,gastric insufficiency,unstable guide wire position,gastroscope exit caused guide wire position changed,distance from the torsion ligament(≥40 cm or≤15 cm)(P<0.05).Conclusion The risk factors influencing the success of jejunum tube catheterization under gastroscopy in children under general anaesthesia were various,position change of the guide wire and the gastric insufficiency was the common causes,therefore it is necessary to analyze in advance before catheterization,and to supplement with corresponding nursing measures,in order to improve the success rate of jejunum tube catheterization and promote one-time success.