红霉素 甲氧氯普胺提高螺旋型鼻肠管幽门后置管成功率的研究

Erythromycin and metoclopramide improves the success rate of post-pyloric placement of the spiral distal end nasal-enteral feeding tubes

目的探讨红霉素和甲氧氯普胺能否提高螺旋型鼻肠管幽门后置管成功率。方法收集2006年7月至2007年3月广东省人民医院急危重症医学部收治的连续120例须行肠道营养的危重患者,随机分为红霉素组、甲氧氯普胺组和对照组,无引导情况下放置螺旋型鼻肠管,红霉素组置管前给予乳糖酸红霉素250mg静脉滴注,12h后重复使用;甲氧氯普胺组置管前给予甲氧氯普胺10mg静脉注射,12h后重复使用;对照组不给促胃肠动力药。置管24h后行床边X线腹部摄片,确认管端位置。结果红霉素组和甲氧氯普胺组幽门后置管成功率分别为74.3%(29/39)和71.8%(28/39),明显高于对照组的42.8%(18/42)(P均<0.05)。结论红霉素和甲氧氯普胺可提高螺旋型鼻肠管幽门后置管成功率。

Objective To determine whether intravenous infusion of erythromycin or metoclopramide can improve the success rate of post-pyloric placement of the spiral distai end nasal-enteral feeding tubes in critically ill patients. Methods One hundred and twenty critically ill patients were randomly divided into 3 groups. 250 mg erythromycin and 10 mg of metoclopramide were given intravenously to patients in the erythromycin group and metoclopramide group before tube insertion respectively, and the dosages were repeated after 12 hours, while no gastrointestinal prokinetic agent was given to other patients as control group. 24 hours later, an abdominal radiography was obtained at the bedside to locate the position of the feeding tube. Results The success rate of tube placement was 74. 3% （29/39） in the erythromycin group, and 71.8% （28/39） in the metoclopramide group, both significantly higher than that 42. 8% （18/42） in the control group（P 〈 0. 05）. Conclusion Intravenous infusion of erythromycin or metoclopramide can improve the success rate of post-pyloric placement of the spiral distal end nasal-enteral feeding tubes in critically ill patients.