改良插胃管术在昏迷气管切开患者中的护理体会

Nursing experience in modified gastric tube insertion procedure in coma patients undergoing tracheotomy

目的研究昏迷气管切开患者改良插胃管术的临床护理体会。方法选择2015年1月—2015年12月收治施行插胃管的80例昏迷气管切开患者为研究对象。根据插管方式的不同分为两组,其中采用常规传统方法插胃管术的40例患者为对照组,采用改良插胃管术的40例患者作为观察组;观察两组患者一次插管成功率、术后24 h误吸与血氧饱和度下降的发生率。结果观察组(改良法)一次置管成功率(95.0%)高于对照组(62.5%),观察组(改良法)患者插管术后24 h内误吸发生率(2.5%)低于对照组(25.0%),观察组(改良法)血氧饱和度下降率(12.5%)低于对照组(80.0%),结果具有统计学意义(P<0.05)。结论昏迷气管切开患者实施改良后的插胃管术,提高一次插管成功率,有效减少反复插管,降低插管后不良反应发生率,减轻患者的痛苦,值得临床应用及推广。

Objective To summarize the nursing experience in modified gastric tube insertion procedure in coma patients undergoing tracheotomy. Methods Eighty coma patients undergoing tracheotomy in Department of General Surgery in our hospital between January 2015 and December 2015 were selected. Patients were divided into control group and observation group according to different procedures of gastric tube insertion,with 40 cases in each group.Patients in control group underwent conventional gastric tube insertion procedure,and those in observation group were managed with improved gastric tube insertion procedure. The success rates of first intubation and the incidences of aspiration 24 h after intubation and oxygen saturation decrease after intubation were compared between two groups.Results The success rate of first intubation in observation group（95.0%）was significantly higher than that in control group（62.5%）,the incidence of aspiration 24 h after intubation in observation group（2.5%）was significantly lower than that in control group（25.0%）,and the incidence of oxygen saturation decrease in observation group（12.5%）was significantly lower than that in control group（80.0%）（P〈0.05）. Conclusion For coma patients undergoing tracheotomy,modified gastric tube insertion procedure improves the success rate of first intubation,decreases the incidences of repeat intubation and adverse reactions after intubation,and reduces the pain of patients. Therefore,it is worthy of clinical application.