经鼻放置多功能胃肠管在神经外科昏迷患者中的应用

Application of the Multifunctional Gastrointestinal Tube Placed Through the Nose in the Patients With Coma in Department of Neurosurgery

目的探讨经鼻放置多功能胃肠管对神经外科昏迷患者中的应用效果。方法选择2014年3月-2015年3月我院神经外科昏迷患者80例,将其随机分为观察组和对照组,每组各40例,观察组经鼻放置多功能胃肠管,对照组经皮胃造瘘放置胃管,比较两组患者置管并发症、置管不同时间营养指标、置管6个月后GOS评分,以及两组患者置管手术时间及置管费用。结果两组患者置管后胃肠道并发症及吸入性肺炎发生率比较,差异均无统计学意义(P>0.05);两组患者置管不同时间前白蛋白、血红蛋白以及外周淋巴细胞百分比比较差异均无统计学意义(P>0.05);两组患者置管6个月后GOS无显著差异(P>0.05);观察组置管手术时间及费用均显著低于对照组(P<0.05)。结论经鼻放置多功能胃肠管在保证患者营养而不影响患者预后的前提下,便于护理且为无创新操作,同时经鼻放置多功能胃肠管较经皮胃造瘘放置胃管手术时间短且费用低,具有着明显的优势,值得临床推广运用。

Objective To explore the application and analysis of the multifunctional gastrointestinal tube placed through the nose in the patients with coma in Department of neurosurgery. Methods March 2014 to March 2015 our hospital neurosurgical coma patients 80 cases, were randomly divided into observation group and control group, each with 40 cases in each. Observation group nasal placed muhifunctional gastrointestinal tube, control group by skin stomach fistula prevention and treatment of gastric tube. Two groups of patients with set tube complications, intubation nutrition index were compared at different time, set six months after the GOS scores, and two groups of patients home tube operation time and catheter cost. Results Two groups of patients placed tube after gastrointestinal complications and aspiration pneumonitis occurrence rate, and the difference was not statistically significant （ P 〉 0. 05 ）. Two groups of patients placed tube different time pre albumin, hemoglobin and peripheral lymphocyte percentage difference were not statistically significant （ P 〉 0.05 ） ; Two groups of pa- tients with PICC tube after six months of GOS score no significant difference （ P 〉 0. 05 ） ; Observation group patients catheter operation time and catheter costs were significantly lower than those in the control group （ P 〈 0.05 ）. Conclusion Tran-snasal placed multifunctional gastrointestinal tube to ensure patients nutrition without affecting the premise of the prognosis of patients for nursing and creativity, and nasal placed muhifunetional gastrointestinal tube is percutaneous gastric fistula placed tube operation time and low cost, obvious advantages, which is worthy of clinical popularization and application.