有创机械通气患者不同时间置胃管比较研究

Comparative study of indwelling gastric tube at different times in patients with invasive mechanical ventilation

目的 对有创机械通气患者不同时间置胃管的效果进行比较研究.方法 采用随机抽样的方法将入院即行气管插管机械通气的患者160例分为2组,每组80例.2组患者均由固定的护士按常规方法放置胃管.观察组采用在气管插管后早期（立即）放置普通硅胶胃管;对照组仍采用在气管插管后晚期（24h后）放置普通硅胶胃管.观察2组患者放置胃管的1次成功率、总的成功率、操作时间及2种判断方法的结果情况.结果 观察组置胃管1次成功率和总的成功率分别为75.0%（60/80）、97.5%（78/80）,明显高于对照组的27.5%（22/80）、72.5%（58/80）,差异有统计学意义（χ2=36.12、19.61,均P〈0.01）.观察组置胃管操作时间为（1.49±0.45）min,明显低于对照组的（3.07±0.32）min,差异有统计学意义（t=25.48,P〈0.01）.观察组只听到气过水声未抽到胃液10例（12.50%）,只抽到胃液未听到气过水声0例,两者均可70例（87.50%）,两者均不可0例,对照组分别为37例（46.25%）、0例、40例（50.00%）、3例（3.75%）.2组患者判断置胃管成功方法结果比较差异有统计学意义（χ2=39.36,P〈0.01）.结论 气管插管后早期（立即）放置普通硅胶胃管提高了机械通气患者置胃管成功率,可以缩短操作时间,提高工作效率,减轻患者痛苦.

Objective Comparative study of gastric tube implantation at different times in patients with invasive mechanical ventilation. Methods Random sampling was used to divide 160 patients who were incubated with mechanical ventilation at the hospital into two groups,There were 80 patients in each group. Two groups of patients were routinely placed gastric tube by a stationary nurse.The observation group was treated with ordinary silica gel stomach tube at early stage（immediately）after trachea cannula, the control group still used the ordinary silica gel stomach tube after the trachea cannula late （24 hours later）.The one-time successful rate,the total successful rate,the operation time and the result of the two Methods were observed in the two groups. Results The observation group Placing stomach tube one-time successful rate and the total successful rate was 75% （60/80）, 97.5% （78/80）, significantly higher than the control group 27.5%（22/80）,72.5%（58/80）,the difference was statistically significant（χ2=36.12, 19.61,P〈0.01）.The operation time of gastric tube in observation group was（1.49 ± 0.45）min,which was significantly lower than that of control group（3.07 ± 0.32）min,the difference was statistically significant （t=25.48,P〈0.01）.The observation group only heard gurgling not pumped to the gastric juice of 10 cases （12.50%）, only smoke into the gastric juice does not hear the gurgling in 0 cases, both in 70 cases （87.50%）,both in 0 cases,the control group were 37 cases（46.25%）,0 cases,40 cases（50.00%）,3 cases （3.75%）. There were significant differences between the 2 groups in determining the success of gastric tube placement,and the difference was statistically significant（χ2=39.36,P〈0.01）. Conclusions After the trachea cannula,the ordinary silica gel gastric tube was placed in the early stage（immediately）,which improved the successful rate of gastric tube placement in the mechanical ventilation patients, Shortened the operation time,improved the work efficiency and alleviated the patient＇s pain.