新生儿经口胃管喂养时三种胃管置入深度体表测量方法的效果比较

Effect comparison of three methods for measuring the depth of gastric tube placement in neonates fed by oral

目的探究新生儿经口胃管喂养时三种胃管置入深度体表测量方法的效果。方法选取2017年6月~2018年6月在广西壮族自治区人民医院新生儿科就诊的180例经口胃管喂养的新生儿,采用随机数字表法分为三组,每组各60例。入组后三组患儿行常规身体检查,记录各组患儿性别、年龄、体重、身长等一般资料。三组患儿均行经口胃管置入,置入成功后分别采用不同方法测量胃管置入的长度,A组测量前额正中发际至剑突的距离;B组测量耳垂至鼻尖+鼻尖至剑突的距离;C组测量眉心(鼻根)至肚脐的距离。比较各组患儿胃管置入深度及与胸片测量值之间差值,统计置管后一次胃液回抽成功率及喂养相关并发症的发生率。结果三组胃管置入深度比较,差异有统计学意义(P<0.05)。C组一次胃液回抽成功率显著高于A、B两组,且B组一次胃液回抽成功率显著高于A组,差异均有高度统计学意义(P<0.01)。C组喂养相关并发症的发生率显著低于A、B两组;B组喂养相关并发症的发生率显著低于A组,差异均有统计学意义(P<0.05)。结论眉心(鼻根)至肚脐距离测量法更接近新生儿的生理解剖值,且该方法能增加患儿置管一次胃液回抽成功率,降低喂养相关并发症的发生率。

Objective To explore the effects of three methods for measuring the depth of gastric tube placement in neonates fed by oral. Methods From June 2017 to June 2018, 180 neonates who received oral feeding in the People′s Hospital of Guangxi Zhuang Autonomous Region were selected. They were divided into three groups according to random number table method, 60 cases in each group. After enrollment, children of the three groups were given the routine physical examination, and sex, age, weight, body length and other general information were recorded. Neonates of the three groups were placed the tube through the mouth. After successful placement, different methods were used to measure the length of stomach tube placement, the distance from median forehead to xiphoid process was measured in Group A;the distance from earlobe to nasal tip + nasal tip to xiphoid process was measured in Group B;the distance from eyebrow (nasal root) to the navel was measured in Group C. The differences between the depth of gastric tube placement and the imaging value were compared among three groups, and the one-time success rate of gastric juice withdrawal after catheterization and the incidence of related feeding complications were counted. Results There were statistically significant differences in the depth of gastric tube placement among the three groups (P < 0.05). The one-time success rate of gastric juice withdrawal of Group C was significantly higher than Group A and B, and the one-time success rate of gastric juice withdrawal of Group B was significantly higher than that of Group A, the differences were highly statistically significant (P < 0.01). The incidence of related feeding complications in Group C was significantly lower than that in Group A and Group B. The incidence of feeding complications in Group B was significantly lower than that in Group A, the differences were statistically significant (P < 0.05). Conclusion The distance between the eyebrows (nose root) and the navel is closer to the physiological and anatomical value of the newborn, and this method can increase the success rate of gastric juice withdrawal after catheterization and reduce the incidence of related feeding complications.