摘要
目的探讨体表胃肠起搏在神经重症患者床旁主动盲插鼻肠管中的应用效果,为临床护理人员优化床旁主动盲插鼻肠管操作流程、提高幽门后置管成功率提供依据。方法采用随机对照研究连续性抽样方法选取2022年2月至2023年1月入住金湖县人民医院重症医学科的神经重症患者70例,按照入院先后时间顺序产生编号,采用随机数字表法分为对照组和观察组各35例。对照组床旁主动盲插鼻肠管中使用甲氧氯普胺肌内注射和胃内注入空气促进胃肠蠕动,观察组使用体表胃肠起搏促进胃肠蠕动。比较2组患者鼻肠管幽门后置管成功率、置管时间、疼痛程度的差异性。结果对照组鼻肠管幽门后置管成功率为51.42%(18/35),观察组为82.85%(29/35),2组比较差异有统计学意义(χ^(2)=7.83,P<0.01);对照组置管时间为(15.83±3.93)min,重症监护室疼痛观察工具(CPOT)评分为(3.32±0.63)分,观察组置管时间为(3.78±0.81)min,CPOT评分为(1.03±0.22)分,2组比较差异有统计学意义(t=13.16、14.65,均P<0.01)。结论神经重症患者床旁主动盲插鼻肠管操作时采取体表胃肠起搏促进胃肠蠕动,可以提高鼻肠管幽门后置管成功率,减少置管时间,减轻疼痛,值得临床推广。
Objective To explore the efficacy of the application of surface gastrointestinal pacing treatment in bedside blind placement of gastrointestinal intubation in patients with severe nervous system diseases and ultimately help clinical nursing staff optimize the intubation process and increase the success rate of post-pyloric placement.Methods This study was a randomized controlled study.A total of 70 patients with severe nervous system diseases who were admitted to ICU of Jinhu People's Hospital from February 2022 to January 2023 were selected by successive sampling method and numbered according to the time sequence of admission,and were divided into The control group with 35 cases and observation group with 35 cases according to the random number table method.The control group used the routine bedside blind placement of gastrointestinal intubation and received metoclopramide intramuscular injection and gastric air injection to promote gastrointestinal peristalsis,while the observation group received surface gastrointestinal pacing treatment to promote gastrointestinal peristalsis.The differences in success rate,incubation time and pain degree of post-pyloric placement of gastrointestinal intubation were compared between the two groups.Results The success rate of post-pyloric placement was 51.42%(18/35)in the control group and 82.85%(29/35)in the observation group,and the difference was statistically significant(χ^(2)=7.83,P<0.01).The incubation time of the control group was(15.83±3.93)min,and the Critical Care Pain Observation Tool(CPOT)scored(3.32±0.63)points,while the incubation time of the observation group was(3.78±0.81)min,and the CPOT scored(1.03±0.22)points,the differences between the two groups were statistically significant(t=13.16,14.65,both P<0.01).Conclusions The application of surface gastrointestinal pacing treatment in bedside blind placement of gastrointestinal intubation to promote gastrointestinal peristalsis in patients with severe nervous system diseases can increase the success rate of post-pyloric placement of gastrointestinal intubation,reduce incubation time,alleviate pain.All in all,it is worthy of clinical application.
作者
刘云
窦子凤
耿湘
高佳
Liu Yun;Dou Zifeng;Geng Xiang;Gao Jia(ICU,Jinhu People's Hospital,Huaian 211600,China;Nursing Department,Jinhu People's Hospital,Huaian 211600,China)
出处
《中国实用护理杂志》
2023年第34期2655-2659,共5页
Chinese Journal of Practical Nursing
关键词
插管法
胃肠
肠内营养
神经重症
床旁盲插
胃肠起搏
Intubation,gastrointestinal
Enteral nutrition
Severe nervous system diseases
Bedside blind placement
Gastroenteric pacing
