新型"子弹头"鼻肠管置管在EICU机械通气患者中的应用

Application of new bullet-shaped nasointestinal tube in patients with mechanical ventilation in EICU

目的探讨新型"子弹头"鼻肠管置管在EICU机械通气患者中的有效性和安全性.方法收集行床边徒手留置鼻肠管的重症脑卒中机械通气患者作为观察对象,按随机数字表法分为观察组和对照组,每组30例.对照组给予传统"螺旋形"鼻肠管置管,观察组给予新型"子弹头"鼻肠管置管.记录置管时间、置管长度、置管位置,统计置管成功率,计算置管成本,并记录置管过程中不良反应发生情况.结果观察组置管长度为(110.78±7.49)cm,长于对照组的(104.83±5.27)cm(t=3.559,P<0.05),置管成功率为93.33%,高于对照组的73.33%(χ2=4.320,P<0.05);观察组置管时间为(26.89±5.32)min、置管成本为(687.54±53.20)元,均少于对照组的(31.24±7.28)min、(741.26±59.48)元(t=2.642,P<0.05;t=3.687,P<0.05);观察组置管过程中不良反应总发生率为3.33%,低于对照组的23.33%(χ2=5.192,P<0.05).结论新型"子弹头"鼻肠管置管能够提高EICU重症脑卒中机械通气患者床旁徒手置管中的置管成功率,降低不良反应,且置管耗时短,可节约医护人员操作时间,节省置管成本.

Objective To investigate the efficacy and safety of a new bullet-shaped nasointestinal catheter in patients with mechanical ventilation in EICU. Methods Patients with severe stroke mechanical ventilation admitted to our hospital from June 2018 to June 2019 were enrolled in the study. The patients were divided into observation group and control group according to the random number table method(n=30). In control group, patients were given with traditional spiral nasointestinal tube, and in observation group they received the new bullet-shaped nasointestinal tube. The catheterization time, the length of the catheter, the position of the catheter were recorded. The success rate of catheterization was counted. The cost of catheterization was recorded. The occurrence of adverse reactions during the catheterization process was recorded. Results The length of the catheter in the observation group was 110.78±7.49 cm, which was significantly longer than that of the control group(104.83±5.27 cm, t=3.559, P<0.05). The success rate of catheter placement was 93.33% in the observation group, which was significantly higher than that of the control group(73.33%, χ~2=4.320, P<0.05). The catheterization time of the observation group was 26.89±5.32 min, and the cost of catheterization was 687.54±53.20 yuan, which were significantly less than those of the control group(31.24±7.28 min and 741.26±59.48 yuan, respectively;P<0.05). The total incidence of adverse reactions during the catheterization of the observation group was 3.33%, which was significantly lower than that of the control group of(23.33%, χ~2=5.192, P<0.05). Conclusion The new bullet-shaped nasointestinal tube can improve the success rate of catheterization in the bedside manual catheterization for patients with severe stroke in EICU, with less adverse reactions and cost, and shorter operating time.