螺旋型鼻肠管在脑损伤患者中的幽门通过率及影响因素

目的研究螺旋型鼻肠管在脑损伤患者中的幽门通过率及影响因素。方法连续纳入2007年9月～2008年3月间重症加强医疗病房收治的脑损伤患者,放置螺旋型鼻肠管并观察置管后24、48和72小时的幽门通过率。判断导管通过幽门的方法包括注气听诊、管腔液体抽吸pH测定和X线腹部平片,并以X线检查作为最终判断指标。记录患者的一般资料、病情严重程度及治疗措施、应用药物和液体平衡等情况,并应用Logistic回归分析确定影响导管通过幽门的因素。结果共纳入83例有完整资料的脑损伤患者。置管后72小时的幽门通过率为68.7%。以X线腹部平片为金标准,管腔液体抽吸pH测定在判断导管通过幽门时的诊断符合率(90.7%)高于注气听诊(65.6%)。导管通过幽门的影响因素包括格拉斯哥昏迷评分、是否接受手术治疗、机械通气以及置管时是否应用乌拉地尔。结论螺旋型鼻肠管在脑损伤患者中具有较高的幽门通过率,有助于早期开展小肠营养。

Rate and Influencing Factors of Postpyloric Migration of Spiral Nasojejunal Tubes in Brain Injured Patients

Objective To investigate the success rate and influencing factors of spiral nasojejunal tube in brain injured patients.Methods Form September 2007 to March 2008,consecutive brain injured patients who admitted to the Intensive Care Unit were enrolled in this perspective cohort study.After patient s admission,a spiral nasojejunal tube was inserted and the positions of these tubes were observed 24,48,and 72 hours after the insertion.Postpyloric progression of the tube was assessed by auscultation,liquid aspira...