两种留置胃管方法的临床分析

Analysis on two methods of indwelling gastric tube

目的通过对两种留置胃管方法的临床研究，探讨盐酸利多卡因胶浆在患者留置胃管护理中的应用效果。方法选择2016年1月-2017年1月该科住院留置胃管的患者160例，随机分为实验组和对照组各80例。‘对照组采用常规方法留置胃管，实验组采用盐酸利多卡因胶浆和石蜡油混合液润滑胃管，并联合口服盐酸利多卡因胶浆局部麻醉后行经鼻留置胃管，观察比较两组患者置胃管前和置胃管成功后的血压、心率、置管一次成功率、置管时间、置管不适反应、耐受程度。结果实验组鼻咽部疼痛、恶心、流泪、血压升高、心率升高、呕吐、呛咳、黏膜出血等不适症状明显低于对照组（均P〈0．01）。实验组一次置管成功率高于对照组（P〈0．05）。实验组置管时平均血压、心率明显低于对照组，留置胃管时间明显短于对照组（均P〈0．01）。实验组耐受度0级、I级明显高于对照组（均P〈0．01），II级明显低于对照组（P〈0．01），III级明显低于对照组（P〈0．05）。结论留置胃管前盐酸利多卡因胶浆的应用，减少了患者的不良反应，提高了患者的舒适度，缓解了患者的紧张情绪，缩短了留置胃管时间，提高了一次置管成功率，具有安全可行性。

Objective To explore the application value of lidocaine hydrochloride gel in the nursing of in- dwelling gastric tube by clinical study of two methods of indwelling gastric tube. Methods A total of 160 cases of pa- tients with gastric tube indwelling admitted to this hospital from January 2016 to January 2017 in the experimental group were selected. They were randomly divided into the experimental group and the control group, 80 cases of each group. The control group was given gastric tube indwelling by routine method. In the experimental group, the gastric tube was lubricated with a mixture of lidocaine hydrochloride and paraffin oil and combined with oral lidocaine hydrochloride The blood pressure, heart rate, primary success rate, duration, discomfort and tolerance of patients in the two groups before and after gastric catheterization were observed and compared. Results Nasopharyngeal pain, nausea, tears, aised blood pressure, elevated heart rate, vomiting, coughing, mucosal hemorrhage and other discomfort symptoms were significantly lower than those in the control group （ P〈0. 01 ）. The success rate of primary catheterization of the experimental group was higher than that of the control group （P〈0. 05）. The mean blood pressure and heart rate of the experimental group were significantly lower than those of the control group, and the time of indwelling gastric tube was shorter than that of the control group （P〈0. 01 ）. The tolerance level 0 and level I of the experimental group were sig- nificantly higher than those of the control group （P〈0. 01 ）, level II was significantly lower than the control group （P〈 0. 01 ） . and level III was significantly lower than the control group （P〈0.05）. Conclusions The application of hdo- caine hydrochloride gel before gastric catheter indwelling reduces the adverse reactions of patients, improves the comfort level of patients, relieves the tension of patients, shortens the time of indwelling gastric catheter, and improves the success rate of primary catheterization. It is safe and feasible.