极低出生体重儿口饲胃管体表测量方法研究

Study on measurement of gastric tube surface of very low birth weight infants by oral feeding

目的探讨极低出生体重儿(VLBWI)经口置入胃管最佳深度的体表测量方法,以减少喂养并发症的发生。方法选择2019年2月~2021年6月在我院经口留置胃管进行喂养的VLBWI 80例,随机分为观察组和对照组各40例。观察组测量“印堂穴-剑突和脐部的中点”长度,按此长度置入胃管口饲;对照组采用“耳垂-鼻尖-剑突”测量法置入胃管口饲。观察并记录两组测量方法测量的刻度准确置入胃管后抽出胃液例数、胃管置入长度(管端至口唇的厘米数)以及两组患儿发生溢乳、呕吐、腹胀等喂养并发症发生率。结果观察组经口置入胃管长度为(15.75±0.25)cm,对照组经口置入胃管长度为(13.64±0.53)cm,两组患儿的胃管留置长度比较差异具有统计学意义(t=22.7726,P<0.05)。观察组置管后抽出胃液35例(87.5%),对照组抽出胃液19例(47.5%),两组患儿置入胃管后抽出胃液例数比较差异有统计学意义(χ^(2)=13.0,P<0.05)。观察组患儿发生溢乳、呕吐、腹胀等喂养并发症7例(17.5%),对照组为21例(52.5%),两组并发症发生率比较差异有显著性意义(P<0.01)。结论极低出生体重儿采用“印堂穴-剑突和脐部的中点”体表测量方法经口置入胃管较“耳垂-鼻尖-剑突”测量法更适宜,可减少管饲喂养并发症。

Objective To evaluate the best depth of gastric tube for very low birth weight infants(VLBWI)and to reduce the incidence of feeding complications.Methods 80 VLBWI patients who received oral indwelling gastric tube feeding in our hospital from February 2019 to June 2021 were randomly divided into observation group and control group(40 cases in each group).The observation group measured the length of"Yintang point xiphoid and midpoint of umbilical cord",and put gastric tube into oral feeding according to the length.The control group was fed with gastric tube and mouth feeding method of"earlobe,nose tip,sword process".The number of cases of gastric juice extraction after gastric tube placement,the length of gastric tube placement(cm from tube end to mouth)and the incidence of feeding complications such as galactorrhea,vomiting and abdominal distension in the two groups were observed and recorded.Results The length of gastric tube was(15.75±0.25)cm in the observation group and(13.64±0.53)cm in the control group,and there was statistically significant difference in the indent length of gastric tube between the two groups(t=22.7726,P<0.05).There were 35(87.5%)patients in observation group and 19(47.5%)patients in control group who extracted gastric juice after gastric tube(χ^(2)=13.0,P<0.05).There were 7 cases(17.5%)in the observation group and 21 cases(52.5%)in the control group,respectively,and the incidence of complications between the two groups was significant(P<0.01).Conclusion The method of"Yintang xiphoid and midpoint of umbilical cord"is more suitable than that of"earlobe,nose tip,xiphoid",which can reduce the complications of tube feeding.