神经重症患者直型鼻肠管置管影响因素分析

Influencing factors of straight nasojejunal tubes placement in neurocritical patients

目的研究直型鼻肠管弯曲上举法在神经重症患者置管中的一性次成功率及影响因素。方法选取2018-01至2020-12常州市第一人民医院神经外科监护室以弯曲上举法置入直型鼻肠管的重症患者作为研究对象,统计置管的一次性置管成功率,应用多元Logistic回归分析置管成功的影响因素。结果共纳入120例神经外科重症患者,其中一次性置管成功99例,置管成功率为82.5%。其中格拉斯哥昏迷评分(Glasgow Coma Scale,GCS)、亚低温治疗以及血钾为影响置管成功的独立影响因素。结论直型鼻肠管弯曲上举法在神经外科重症患者的成功率较高,患者GCS评分<5分,低血钾,亚低温治疗可影响置管成功率,置管前应予以重视并选择合适的置管时机。

Objective To study the one-time success rate and influencing factors of straight nasojejunal tubes placement in neurocritical patients. Methods Neurosurgery intensive care unit patients with straight nasojejunal tubes from January 2017 to June 2018 were selected as the study subjects. The one-time success rate was calculated, and the influencing factors were analyzed by applying multivariate Logistic regression analysis. Results 120 patients with complete clinical data were enrolled for analysis, 99 patients were successfully placed, the one-time success rate was 82.5%. The Glasgow Coma Scale(GCS), subcritical treatment and blood potassium were independent influences on the success of the tube placement. Conclusion The one-time success rate of the bent uplift method was relatively high in neurosurgical intensive care patients with GCS<5. Hypokalemia and mild hypothermia therapy can affect the success rate.Attention should be paid and the appropriate time should be chosen before catheterization.