反弧度鼻胃管置入结合抬下颌法在昏迷患者中的应用

Indwelling stomach tube in anti-arc with the mandibular packed in unconscious patients

目的:探讨反弧度鼻胃管置入结合抬下颌法在昏迷患者中的应用。方法:将70例ICU昏迷患者随机分为对照组和改良组各35例。对照组采用传统方法置管,改良组采用抬下颌后反弧度插入鼻胃管并以B超下食管内定位的方法,比较2组患者一次性置管成功率,鼻黏膜损伤率,血氧饱和度下降率,血压升高率以及心率上升率;且对照组一次性置管失败后用改良组方法进行置管,记录补救后一次性置管成功率。结果:改良组一次性置管成功率为94.3%,对照组一次性置管成功率为54.3%(P<0.05),对照组一次性置管失败再用改良组方法补救置管后一次性置管成功率为100%。结论:采用抬下颌后反弧度插入鼻胃管可提高一次性置管成功率,未增加食管黏膜的损伤率,降低了置管时不良反应的发生率,减轻患者的痛苦。

[Objective]To discuss the success ration of the stomach tube indwelling in unconscious patients by the modified method. [Method]70 unconscious patients in ICU were randomly divided into two groups. The control group（ n= 35） received the routine method; in the observation group（ n = 35）,the stomach tube used to carry mandibular anti arc insertion of nasogastric tube and method of positioning the esophagus under B- mode ultrasound. The success rate of disposable intubation,nasal mucosa injury rate,oxygen saturation rate,blood pressure and heart rate were compared between these 2 groups.. If the first indwelling was failed in control group,the modified method of observation group was used（ rescue group）,and record the success rate. [Result]The success rate of the stomach tube imbedding at the first time in observation group was 94. 3%,in control group was 54. 3%,and in rescue group was 100%. [Conclusion]The modified method can improve the success rate of stomach tube at the first time indwelling in the critical patients,the damage rate of esophageal mucosa was not increased,and the incidence of adverse reactions was decreased.,and patients＇ suffering was lightened.