重症患者超声引导下行三腔胃肠管置入的实践

The application and effect of ultrasonography guided intubation of Freka Trelumina nasojejunal tubes in critical patients

目的探索应用超声引导进行三腔胃肠管置入的可行性及效果。方法选择2017年12月—2018年9月某三级甲等医院综合ICU中需置入三腔胃肠管的52例重症患者为研究对象。记录采用超声引导三腔胃肠管置入的方法和流程,并分析和评价相应指标,如置管成功率、置管时间、置管并发症、不良事件发生情况、患者配合度及临床应用效果等。结果 52例患者中50例置管成功,置管成功率为96.15%,置管时间为(26.58±8.01) min。置管过程中清醒患者配合度较好,92.3%的患者无呛咳或较轻微,无患者出现咽部损伤、误吸、胃肠道穿孔等并发症。所有患者置入导管位置良好,胃肠减压和肠内营养支持效果较好,无管道脱出发生。结论采用超声引导的方法进行三腔胃肠管置入具有较好的可行性,可为重症患者早期肠内营养支持提供借鉴。

Objective To explore the feasibility and clinical efficacy of ultrasonography guided placement of Freka Trelumina nasojejunal tubes. Methods From December 2017 to September 2018,52 hospitalized patients who needed Freka Trelumina nasojejunaltube were enrolled into our study from a comprehensive ICU in a tertiary hospital. The method and process of ultrasonography guided intubation were recorded,and indicators such as successful rate,length of operation,adverse reactions,compliance and clinical effects were recorded for analysis. Results Totally 50 out of 52(96.15%) patients were successfully intubated and length of operation was(26.58±8.01) min. The awaken patients had good compliance,92.3% of the patients had no cough or slight cough during intubation,and nobody experienced pharyngeal injury,aspiration,gastrointestinal perforation or any other complications. All successfully intubated patients had satisfied catheter position,gastrointestinal decompression and enteral nutrition supporting,and no tube prolapse occurred. Conclusion Ultrasonography guided intubation of Freka Trelumina nasojejunaltube isa feasible and effective new method,and can be recommended for tube establishment of early enteral nutritionsupport in critical patients.