新型“子弹头”与螺旋型鼻肠管对颅脑损伤术后患者营养状态及预后的影响

Effects of different types of naso intestinal tubes on nutritional status and prognosis of patients with craniocerebral injury

目的:探讨新型“子弹头”与螺旋型鼻肠管两种类型鼻肠管对颅脑损伤术后营养状态及预后的影响。方法:将100例颅脑损伤手术患者按纳入的随机序号分为奇数组(A组)和偶数组(B组),每组各50例。两组患者均采用肠内营养,A组采用螺旋型鼻肠管,B组采用新型“子弹头”鼻肠管。比较两组患者的置管情况、营养状态、反流误吸发生情况及预后。结果:B组患者的置管成功率高于A组,置管时间少于A组,置管长度长于A组,差异均有统计学意义(P<0.05)。两组置管第7天时的血清前白蛋白(PA)、白蛋白(ALB)、血红蛋白(Hb)比较,差异无统计学意义(P>0.05)。两组营养支持第14天时的GCS评分、APACHE II比较,差异无统计学意义(P>0.05)。B组患者误吸、反流、腹泻、消化道出血的发生率略低于A组,但差异均无统计学意义(P>0.05);B组的堵管发生率高于A组,差异有统计学意义(P<0.05)。结论:与螺旋型鼻肠管比较,新型“子弹头”鼻肠管的置管成功率更高,置管耗时更短,有一定的推广应用价值。

Objective:To investigate the effects of new“bullet”and spiral naso intestinal tube on nutritional status and prognosis after craniocerebral injury.Methods:100 patients with craniocerebral injury were randomly divided two groups according to the group number,which the odd number was the group A and the even number was the group B,with 50 cases in each group.Enteral nutrition was used in both groups.Spiral naso intestinal tube was used in group A and new“bullet”naso intestinal tube was used in group B.The catheterization,nutritional status,incidence of reflux aspiration and prognosis were compared between the two groups.Results:The success rate of catheterization in group B was higher than that in group A,the catheterization time was less than that in group A,and the catheterization length was longer than that in group A,the differences were statistically significant(P<0.05).There was no significant difference in serum prealbumin(PA),albumin(ALB),hemoglobin(HB)between the two groups on the 7th day of catheterization(P>0.05).There was no significant difference in GCS score and APACHE II on the 14th day of nutritional support between the two groups(P>0.05).The incidence of aspiration,reflux,diarrhea and gastrointestinal bleeding in group B were slightly lower than those in group A,but the differences were not statistically significant(P>0.05).The incidence of tube plugging in group B was lower than that in group A,the difference was statistically significant(P<0.05).Conclusion:Compared with spiral naso intestinal tube,the success rate of the new“bullet”naso intestinal tube is higher,the time of tube placement is shorter,the incidence of tube blockage is low,which is worthy of popularization.