新生儿留置胃管非计划性拔除的现况调查与分析

The incidence and influencing factors of unplanned extubation of gastric tube in neonates

目的描述非计划性拔管(UEX)在新生儿留置胃管中的发生现状,分析其原因并探索其对策。方法采用方便抽样,用自制非计划性拔管登记表对2010年10月至2011年3月上海市某三级甲等儿科医院留置胃管的新生儿进行登记。结果共收集220例有效记录,其中非计划性拔管41例(18.6%),按置管日计算的拔管率为1.86次/100个置管日,重新置管率为80.5%。Logistic回归分析发现,患儿有无肢体约束和胃管的固定方式是UEX的影响因素。结论加强巡视、有效的肢体约束、恰当的胃管固定、规范护理操作流程可减少新生儿UEX的发生。

Objective To investigate the incidence of unplanned extubation（UEX） of gastric tube in the neonates,and to analyze the causes and explore the countermeasures. Methods The clinical data of 220 neonates with gastric tube from October 2010 to March 2011 in a children hospital in Shanghai were recorded. Results The incidence of UEX was 18.6 percent and 1.86 per 100 tube days in the neonates with gastric tube. The reintubation rate was 80.5 percent. Logistic regression analysis showed that body restraint and the fixation method of gastric tube were the influencing factors of UEX. Conclusion It is suggested that frequent observation,effective body restraint,proper fixation method and standardized nursing care are helpful to reduce the incidence of unnlanned extubation in neonates with ~astric tube.