经口置胃管在颅底骨折机械通气患者中的应用及护理

Application and nursing of placing stomach tube through mouth in mechanical ventilation patients with basal fracture

目的探讨经口置胃管在颅底骨折机械通气患者中的应用及护理措施。方法32例颅底骨折合并重型颅脑损伤机械通气患者使用带导丝胃管，通过牙垫中央由口留置胃管法。结果置管成功率达100％，一次性置管成功率达93．75％。6例病情好转后经口进食，3例自动出院，拔除胃管，23例分别于7-21d后改为经鼻留置胃管。结论颅底骨折机械通气患者经牙垫由VI置人胃管，成功率高，同时予以严密观察、认真评估、妥善固定亦至关重要。

Objective To explore application and nursing measures of placing stomach tube through mouth in mechanical ventilation patients with basal fracture. Methods 32 patients with basicranial fracture complicated with severe craniocerebral injury treated with mechanical ventila- tion were placed stomach tube with thread through the central of teeth pad. Results The success rate of tube placing was 100%, among which one- time success rate was 93.75%. 6 patients got better and they were able to eat by mouth. 3 patients pulled out the tube and auto- discharged. 23 patients turned to nasal indwelling gastric tube in 7-21 days. Conclusion Placing stomach tube for basal fracture patients with mechanical ventilation by teeth pad had high success rate. Meanwhile, strict observation, carefully evaluation and properly fixation were also significant.