咽下综合征新生儿不同途径置管洗胃的效果分析

Effect Analysis on Catheter Gastrolavage via Different Pathways in Newborns with Swallowing Syndrome

目的比较咽下综合征新生儿经鼻与经口两种途径置管洗胃的效果。方法选择2007年1月至2009年5月转入某院新生儿重症监护室(newbornintensive care unit,NICU)的60例咽下综合征新生儿,按随机数字表法分为经鼻置管洗胃组(N=30)和经口置管洗胃组(N=30)。分析两种胃管置入方法的一次插管成功率及洗胃期间患儿恶心、面色发绀、呼吸暂停情况及置管前后SpO2的变化。同时,采用新生儿急性疼痛行为评分量表(douleur aigue nouveaune,DAN)评分标准,评价患儿疼痛情况。结果经口置管一次插管成功率为100%,高于经鼻置管的70%,差异有统计学意义(P<0.05)。经口置管洗胃组患儿面色发绀、呼吸暂停发生情况及置管后SpO2下降程度与经鼻置管洗胃组比较,差异有统计学意义(均P<0.05);经口置管洗胃组患儿DAN得分小于经鼻置管洗胃组患儿(P<0.05)。结论经口置管洗胃便于操作,对患儿各方面的影响较小,值得在临床中推广应用。

Objective To compare the effects of nasal and oral catheter gastrolavage in the newborns of NICU.Methods Sixty newborns with swallowing syndrome from January 2007 to May 2009 in the NICU were randomly divided into the nasal catheter gastrolavage group（n=30）and the oral catheter gastrolavage group（n=30）.An analysis was conducted on the success rate of one-time intubation,occurrences of nausea,cyanosis and apnea during catheter gastolavage and the changes of SpO2 before and after indwelling catheter.The pain expressions of the newborns were evaluated with douleur aigue nouveaune（DAN）scoring standard.Results The success rate of one-time oral catheter（100%）was significantly higher than that（70%）of nasal one（P0.05）.Significant differences were observed in occurrences of nausea,cyanosis and apnea during catheter gastolavage and the changes of SpO2 before and after indwelling catheter between the two groups（P0.05）.The DAN scores of oral catheter gastrolavage group were lower than those of the nasal catheter gastrolavage group（P0.05）.Conclusion Oral catheter gastrolavage is more flexible for the newborns with less influence,which deserves clinical popularization.