自制导引器在脑出血昏迷难置胃管患者中的应用

Application of homemade guiding device in cerebral hemorrhage coma patients with difficulty in stomach intubation

目的 探讨适用于脑出血昏迷患者的胃管置入方法.方法 选择河北医科大学附属哈励逊国际和平医院重症医学科2016年1月—2017年6月收治的脑出血昏迷患者120例,应用随机数字表法随机分为3组,3组患者分别使用不同的方法置入胃管.A组采用常规方法置管,B组采用采用喉镜直视下置管法,C组采用明视下应用自制导引器置管法.通过对3组患者的一次性置管成功率、不良反应发生率和置管时间的比较,探讨针对脑出血昏迷患者的合理的置管方法.结果 C组的一次性置管成功率高于B组和A组,差异有统计学意义（P〈0.01）.C组的不良反应发生率低于A组和C组（P〈0.01）,置管时间少于A组和B组（P〈0.01）.结论 应用自制导引器置管法成功率高,能够缩短置管时间,减少不良反应的发生率,适于脑出血昏迷患者使用.

Objective To explore suitable stomach intubation methods for patients with cerebral hemorrhage coma. Methods A total of 120 cases of cerebral hemorrhage coma patients treated in Harrison International Peace Hospital Affiliated to Hebei Medical University from January 2016 to June 2017 were selected and divided into 3 groups using random number table. Patients in 3 groups were applied with different stomach intubation methods. Group A used the conventional method; group B used the laryngoscope to direct the tube placement; group C used homemade guiding catheter. One-time success rates of catheter, incidence of adverse reactions and catheter time were compared between groups to explore reasonable methods for patients with cerebral hemorrhage coma. Results The one-time success rate of catheter of group C was higher than that of group B and group A; the difference was statistically significant （P〈0.01）. The incidence of adverse reactions in group C was lower compared with group A and group B （P〈0.01）, and catheter time of group C was shorter than that in group A and group B （P〈 0.01）. Conclusions Application of homemade guiding device in stomach intubation has a high success rate, can shorten the time of indwelling, and reduce the incidence of adverse reactions, so it is suitable for patients with intracerebral hemorrhage coma.