护理干预下经皮内镜下胃造瘘与鼻饲管置入在老年慢性阻塞性肺部疾病急性发作中的应用对比

Comparison of Application of Percutaneous Endoscopic Gastrostomy under the Nursing Intervention and Nasal Feeding Tube Placement under the Nursing Intervention in the Acute Attack of Senile Chronic Obstructive Disease of Lung

目的探讨护理干预下经皮内镜下胃造瘘在老年慢性阻塞性肺部疾病急性发作患者中的应用价值,并于鼻饲管置入者进行对比。方法选择2014年12月—2015年12月该院收治的老年慢性阻塞性肺部疾病者80例,按照随机数字法分为两组,各40例,观察组行经皮内镜下胃造瘘术,对照组行盲探鼻饲管置入,比较两组住院时间、留置导管期间相关并发症:腹腔感染、肺部感染加重、胃内反流情况,并统计两组抢救成功例数、死亡率。结果观察组住重症监护室时间为(9.1±0.4)d,对照组住重症监护室时间为(11.3±0.5)d,观察组住重症监护室时间显著短于对照组(t=21.305,P=0.000<0.05),观察组发生腹腔感染(7.5%)、肺部感染加重(2.5%)、胃内反流(2.5%)比例低于对照组的5.0%、25.0%及27.5%(P<0.05),观察组抢救成功率为90.0%,显著高于对照组的52.5%(χ~2=11.960,P=0.001<0.05)。结论护理干预下经皮内镜下胃造瘘术,能更好的提高患者救治效率,减少相关并发症,值得临床推广。

Objective To study the/tpplication value of percutaneous endoscopic gastrostomy under the nursing intervention and nasal feeding tube placement in the acute attack of senile chronic obstructive disease of lung. Methods 80 cases of patients with chronic obstructive disease of lung admitted and treated in our hospital from December 2014 to December 2015 were selected and randomly divided into two groups with 40 cases in each, the observation group adopted the percutaneous endoscopic gastrostomy, while the control group adopted the nasal feeding tube placement, and the length of stay, related complications including intra-abdominal infection, exacerbation of pulmonary infection and gastric reflux during catheter indwelling period were compared between the two groups, and the rescue success rate and death rate of the two groups were counted. Results The ICU time in the observation group was obviously shorter than that in the control group [ （9.1±0.4） d vs （11.3±0.5） d] （t=21.305,P=0.000〈0.05）, the incidence rate of intra-ab- dominal infection, exacerbation of pulmonary infection and gastric reflux in the observation group was lower than that in the control group （7.5%, 2.5%, 2.5% vs 5.0%, 25.0%, 27.5%）（P〈0.05）, and the rescue success rate was obviously higher than that in the control group, （90.0% vs 52.5%）（x^2=11.960,P=0.001 〈0.05）. Conclusion The percutaneous endoscopic gastrostomy under the nursing intervention can better improve the treatment efficacy of patients and reduce the related complications, which is worth clinical promotion.