三腔鼻胃空肠管在重症患者中的临床应用

Clinical application of three cavity nasogastric jejunum tube for critical patients

目的观察和总结三腔鼻胃空肠管在重症患者中的临床应用效果。方法本组患者88例,男51例,女37例,年龄22～78岁,在徒手盲插的基础上再在胃镜引导下将三腔鼻胃空肠管空肠尖端段置入空肠。记录置管操作是否顺利,记录置管时间,登记留管时间,观察置管过程及置管后有无并发症。结果 88例患者置管期间无口咽、食管、胃、十二指肠、空肠的损伤、出血、穿孔。置管时间5～28min,平均(12.25±3.68)min。留管时间14～38d,平均(25.30±2.76)d。38例置管前麻痹性肠梗阻者明显缓解或消除。88例未出现误吸、吸入性肺炎等。81例营养状态明显改善。结论胃镜引导下在重症患者中置入三腔鼻胃空肠管简便、快捷、安全、成功率高、并发症少。三腔鼻胃空肠管应用于重症患者可以减少或避免返流、误吸、吸入性肺炎等严重而致命的并发症,同时可以有效地改善重症患者的胃肠道功能和营养状态。

Objective To observe and summarize the clinical application effect of three cavity nasogastric jejunum tube for critical patients. Methods A retrospective analysis of 88 cases, 51 were males and 37 were females, age from 22 to 78 years old. On the basis of blind plug, then let the jejunum tip of three cavity nasogastric jejunum tube into the jejunum by the guidance of gastroscope. Record if the operation was smoothly and how long the operation was taken. Registration the retention time of three cavity nasogastric jejunum tube. Observation if there were any complications of the operation and later. Results There was no oropharyngeal, esophagus, stomach, duodenum, jejunum damage, bleeding and perforation during the operation. The operation takes 5-28 min, and the mean operating time was （12.25 ±3.68） rain. The retention time was 14-38 day, and the mean time was （25.30± 2.76） day. 38 cases of paralytic ileus were obviously alleviate or eliminate, 88 cases do not appear aspiration, aspiration pneumonia.81 cases＇nutritional status markedly improved. Conclusion It is easy,safe,and effective to placement the three cavity nasogastric jejunum tube by the guidance of the gastroscope. The application of three cavity nasogastric jejunum tube can reduce or avoid regurgitation, aspiration, aspiration pneumoniit and other complications in critical patients. It also can effectively improve the patient＇s gastrointestinal function and nutritional status.