不同途径置胃管洗胃的适应群研究

Study on the adaptation group of gastric lavage by different routes of gastric tube placing

目的通过回顾一定数量的口服中毒需要洗胃病例,总结出不同途径置胃管洗胃的适应群。方法回顾性调查2012年1月～2016年1月急诊科就诊的336例口服药物中毒成功置管洗胃病例,根据不同途径置管分为两组:经口组、经鼻组。回顾病例书写内容:病史、患者病情、选择洗胃管插管途径、并发症等。结果存在口腔疾病的患者经鼻置管成功例数较多,存在鼻腔病史的经口置管成功例数较多,而经口或鼻置管的患者黏膜均存在不同程度的黏膜破损。根据患者药物中毒后不同就诊时间置管洗胃堵塞率有所差异,经口组组内比较,越近就餐时间堵塞率越高,经鼻组的堵塞率较经口组高,差异有统计学意义(P<0.05)。结论置胃管前,护士及时评估病史、病情至关重要,根据具体情况不同快速选择不同插管途径,减少插管时间及提高一次插管成功率。

Objective To summarize the adaptation group of different routes of gastric tube placing for gastric lavage by reviewing a certain number of cases with oral poisoning in need of gastric lavage. Methods A total of 336 cases of oral drug poisoning in the emergency department who were successfully given tube placing and gastric lavage from January2012 to January 2016 were retrospectively investigated. According to different routes of tube placing, the two groups were divided into the oral group and the nasal group. The case writing contents were reviewed, including medical history,patients’ condition, choice of routes of tube placing for gastric lavage, complications, etc. Results There were more successful cases of nasal tube placement in the patients with oral diseases. There were more successful cases of oral tube placement in the patients with the history of nasal diseases. There were different degrees of mucosal damages in the mucosa of patients receiving oral or nasal tube placement. According to the different treatment visit time after patients’ drug poisoning, the clogging rates of tube placing for gastric lavage were different. The comparison was carried out within the oral group, and the clogging rate was higher if the eating time was closer to the tube placement time. The clogging rate in the nasal group was higher than that in the oral group, the difference was statistically significant(P<0.05).Conclusion It is utterly important for nurses to timely assess the medical history and conditions before placing the stomach tube. The different intubation routes should be rapidly selected according to specific conditions, so as to reduce the intubation time and increase the success rate of one-time intubation.