胃管耐受性的调查研究

A Research on the Tolerance of the Gastric Tube

目的调查不同疾病的置胃管患者对胃管诱发咽反射所致恶心、干呕、呛咳症状的耐受程度,间接评估喉全切患者及OSAHS患者的咽反射敏感性。方法用视觉模拟标尺法分别观察并记录喉全切患者、OSAHS患者及对照组患者对置胃管时及置胃管3d后恶心、干呕、呛咳症状的耐受程度,并行统计学分析。结果喉全切患者术前置胃管时的恶心、干呕、呛咳程度与对照组患者差异无统计学意义(P>0.05),但在置胃管3d后恶心、干呕、呛咳程度明显低于对照组患者(P<0.05);OSAHS患者置胃管时和留置胃管3d后的恶心、干呕、呛咳程度均明显低于对照组(P<0.05)。三组患者置胃管3d后的恶心、干呕、呛咳程度均较置胃管时明显降低(P<0.05)。结论喉全切术后患者和OSAHS患者置胃管时恶心、干呕、呛咳程度较对照组轻,咽反射敏感度低,胃管耐受性好,并随胃管使用时间的延长,不适程度可减轻。

Objective To investigate the tolerance to gag reflex （such as nausea, retching and choking symptoms） induced by gastric tube of patients with different diseases and the sensitivity to gag reflex of patients with total laryngeal resection and patients with OSAHS. Methods Visual analogue scale method was used to ob- serve and record tolerance to nausea, retching and choking symptoms in the total laryngeal resection patients, OSAHS patients and control group patients, respectively. Statistical analysis was applied consequently. Re- suits Before surgery, the degree of nausea, retching and choking in total laryngeal patients under gastric tube insertion shows no significant difference among groups（P 〉 0.05）. However, this degree became much lower in total laryngeal resection patients after 3d of the insertion of gastric tube compared with that in the control group patients （P 〈0.05）. For OSAHS patients, their degree of nausea, retching and choking, both under gastric tube insertion and 3d after, was significantly less than that in the control group patients. （P 〈0.05）. All the three groups of patients showed a reduction in the degree of nausea, retching and choking after 3d than that under the gastric tube insertion （ P 〈 O. 05 ）. Conclusion Under the insertion of gastric tube, total la- ryngeal resection patients and OSAHS patients suffer less from nausea, retching and choking than the patients in the control group do. These discomforts will also be eased with the extension on the usage of gastric tube.