摘要
目的本研究旨在借助超声可视化特点,结合“R-S-A”三点位行危重症患者超声引导下鼻肠管置入,并评估此技术的精准度、有效性。方法对重庆市某三级甲等医院重症医学科2022年4月-2023年8月收治的全部危重症鼻肠管置管患者进行回顾性分析。根据置管体位分为对照组与观察组,对照组行超声引导下鼻肠管置入,观察组在超声引导的基础上以“R-S-A”三点站位(患者取右侧卧位,置管者站于患者右肩处,超声操作者站于右腹部操作方向)行超声引导下鼻肠管置入,对照组仅在超声引导下行鼻肠管置入,对体位无特殊要求。倾向性评分匹配后比较两组的置管时间、置管成功率、并发症发生情况。结果观察组平均置管时间(36.2±10.3)min短于对照组(42.3±8.3)min,置管成功率95.2%高于对照组66.7%,差异均具有统计学意义(P<0.05)。观察组并发症发生率9.5%少于对照组28.6%,但P>0.05,差异无统计学意义。结论基于“R-S-A”三点位行危重患者超声引导下鼻肠管置入技术精准度高、有效性强,能够缩短置管时间,提高置管成功率。
ObjectiveTo evaluate the precision and effectiveness of ultrasound-guided visualization for nasojejunal tube placement with the“R(right reclining)-S(shoulder)-A(abdominal)”3-point positioning for critically ill patients.MethodsA retrospective analysis was conducted on all critically ill patients who underwent nasojejunal tube placement in Department of Critical Medicine of a tertiary hospital in Chongqing from April 2022 to August 2023.According to the position of the catheter,they were divided into a control group and an observation group.The control group received ultrasound-guided nasojejunal tube insertion,while the observation group used the“R-S-A”3-point positioning(the patient were placed in a right lateral position,the nurse stood at the right shoulder of the patient,and the ultrasound operator stood on the right side of the abdomen in the operating direction)for ultrasound-guided nasojejunal tube insertion.And,the control group had no specific requirements for positioning during the procedure.After propensity matching,the time and success rate of catheter insertion and incidence of complications were compared between the 2 groups.ResultsThe time of catheter insertion was significantly shorter(36.2±10.3 vs 42.3±8.3 min),and the success rate of insertion was obviously higher(95.2%vs 66.7%)in the observation group when compared with the control group(P<0.05).The incidence of complication was 9.5%in the observation group,and 28.6%in the control group,but there was no statistical difference between the 2 groups.ConclusionUltrasound-guided nasojejunal tube placement based on“R-S-A”3-point positioning has high precision and strong effectiveness in critically ill patients,which can shorten the time and improve the success rate of catheter insertion.
作者
陈双梅
刘若萱
谭亮
苏小洪
刘美麟
齐俊生
曹英
CHEN Shuangmei;LIU Ruoxuan;TAN Liang;SU Xiaohong;LIU Meilin;QI Junsheng;CAO Ying(Department of Critical Medicine,First Affiliated Hospital,Army Medical University(Third Military Medical University),Chongqing,400038,China)
出处
《陆军军医大学学报》
CAS
CSCD
北大核心
2024年第18期2145-2151,共7页
Journal of Army Medical University
关键词
危重患者
体位
超声引导
鼻肠管置入
critically ill patients
body position
ultrasound-guidance
nasointestinal tube placement
