“导丝逆退法”在螺旋型鼻肠管置入术中的试验性探索研究

Indwelling spiral nasointestinal tubes by guidewires in the reverse way :A novel method of testing exploration research

目的探索"导丝逆退法"在螺旋型鼻肠管置入术中方法的可行性。方法选取2018年1月-2018年12月就诊于我院诊断中重症、重症急性胰腺炎患者80例为研究对象,随机分成二组,"导丝逆退法"置管术为试验组40例,常规置入法为对照组40例。结果以到达屈氏韧带以下的空肠起始部为置管成功,两组间置管成功率的比较95.0%(38/40)VS 62.5%(25/40),两组间有差异性(χ^2=12.654,P=0.000,P<0.05)。单因素分析插管时间(T=-3.594,P=0.001)、尝试次数(T=9.292,P=0.010)、能否耐受(χ^2=5.0,P=0.025)、恶心呕吐感(χ^2=7.04,P=0.008)是成功与否的关键因素。结论"导丝逆退法"插入螺旋型鼻肠管的方法有简单易操作性、微创伤性与科学合理性,适合在基层医院推广。

Objective To explore the feasibility of Indwelling spiral nasointestinal tubes by guidewires in the reverse way.Method In this study,We divided two randomized controlled trials into the trial group indwelling spiral nasointestinal tube by guidewires in the reverse way and the control group in the conventional placement procedure,involving a total of 80 patients,each group was 40 patients,to compare those variables who were diagnosed with moderately severe and severe acute pancreatitis,in the affiliated hospital of Jiujiang university from Jan 2018 to Dec 2018. Results The jejunum below the ligament of Treitz where spiral nasointestinal tubes were placed into was successfully catheterized,the patients between the trial group and the control group were comparable. Two groups success probability were 95%(38 of 40) Vs 62.5%(25/40),there were significant differences of them(χ^2=12.654,P=0.000,P<0.05). Univariate analysis including of intubation time(T=-3.594,P=0.001),several attempts(T=-3.594,P=0.001),tolerance limit(χ^2=5.0,P=0.025),nausea and vomiting(χ^2=7.04,P=0.008) were signficant factors success. Conclusions The method of Indwelling spiral nasointestinal tube by guidewires in the reverse way is simple,operating easily,minimally invasive and scientific reasonable,which is suitable to be popularized and used in many basic hospitals.