不同胃管置入长度对急性胰腺炎患者恢复的临床护理对照研究

Comparative study of the influence of different length of gastric tube on the recovery of patients with acute pancreatitis

目的探讨不同胃管置入长度对急性胰腺炎患者恢复的影响。方法选取2010年8月至2012年12月在我院治疗的急性水肿型胰腺炎患者63例,随机分成研究组（32例）与对照组（31例）,两组患者入院后治疗措施与用药情况均相同,对照组胃肠减压时胃管置入从患者耳垂-鼻尖-剑突,长度范围45-55 cm,研究组从患者耳垂-鼻尖-剑突与肚脐连线中点（在之前基础上增加5-10 cm）。比较两组患者负压引出液体量、胃管阻塞情况、腹部疼痛减轻所需时间、血清淀粉酶（AMS）指标达到正常所需时间以及患者入院时间。结果研究组患者引出液体量在800 ml以上的比率显著高于对照组,两组比较差异具有显著统计学意义（P〈0.01）;研究组未发生胃管阻塞,而对照组发生胃管阻塞的比率为12.9%,两组比较差异具有显著统计学意义（P〈0.01）;研究组患者腹部疼痛减轻时间、血清淀粉酶达标时间及住院时间均比对照组明显缩短,差异具有统计学意义（P〈0.05）。结论在常规胃管置入的基础上,根据患者年龄、身高等情况适当增加胃管置入长度,能有效提高急性胰腺炎胃肠减压效果,对减轻患者疾痛、促进患者早日恢复具有重要意义,值得临床借鉴。

Objective To explore the influence of different length of gastric tube on the recovery of patients with acute pancreatitis. Methods 63 patients with acute edema type pancreatitis in our hospital from August 2010 to December 2012 were randomly divided into research group（32 cases） and control group（31 cases）. Patients from each group received the same treatment and medications. In control group, the length of gastric tube was measured following the earlobe-tip-xiphoid sequence when the gastrointestinal decompression was carried out in patients. The length of gastric tube ranged from 45 cm to 55 cm. In the research group, the length of gastric tube was measured following earlobe-tip-the attachment point of xiphoid and navel sequence（5-10 cm longer than the basic one）. The liquid volume sucked by vacuum aspiration, gastric tube obstruction, time required to reduce the abdominal pain, time required for serum amylase（AMS） to resume normal and patients＇ s hospitalization time in each group were compared.Results The ratio of liquid volume sucked by vacuum aspiration in the research group was more than 800 ml, whichwas significantly higher than that in control group（P0.01）. There was no gastric tube obstruction in research group,which was statistical significant than that in the control group（12.9%）（P〈0.01）. In research group, the time required to reduce the abdominal pain, the time required for serum amylase（AMS） to resume normal and the hospitalization time were significantly shorter than that in control group（P〈0.05）. Conclusions On the basis of conventional gastric tube placement, increasing the length of gastric tube according to patients＇ age, height and other conditions can effectively improve the effect of gastrointestinal decompression in acute pancreatitis patients. Moreover, it is helpful to ease the pain and promote the recovery of patients.