聚氨酯鼻胃管在高龄长期管饲患者中的留置时间研究

Study on the Indwelling Time of Polyurethane Nasogastric Tube in Elderly Patients with Long-term Tube Feeding

目的通过延长老年患者聚氨酯鼻胃管的留置时间,观察鼻胃管的理化性质及患者鼻咽部黏膜的损伤程度,判定鼻胃管的最佳留置时间。方法选取2018年1月5日至2021年10月26日于解放军总医院第二、三医学中心进行老年鼻饲的患者200例为研究对象,根据留置时间的不同,分为对照组(100例,鼻胃管留置时间为30 d)和试验A、B组(各50例,留置时间分别为30~60 d、60~90 d)。观察鼻胃管拔除后鼻胃管前端的硬度、颜色、反折回弹角度及带管过程中患者鼻咽部黏膜颜色,同时评估患者鼻咽部黏膜损伤情况。结果鼻胃管拔除后,3组鼻胃管前端硬度在不同硬度范围占比比较,差异无统计学意义(χ^(2)=0.36,P>0.05);3组鼻胃管前端颜色增深比例比较,差异无统计学意义(χ^(2)=1.62,P>0.05);3组鼻胃管反折回弹角度在不同回弹角度范围占比比较,差异无统计学意义(χ^(2)=0.73,P>0.05);3组鼻咽部黏膜损伤情况比较,差异无统计学意义(χ^(2)=0.36,P>0.05)。结论聚氨酯鼻胃管最佳留置时间<90 d,可减轻因频繁更换鼻胃管对患者造成的机械性损伤。

Objective To determine the optimal indwelling time of polyurethane nasogastric tube in elderly patients by observing the physical and chemical properties of the tube and the degree of nasopharyngeal mucosa damage.Methods A total of 200 elderly patients with nasal feeding in the Second and Third Medical Center of Chinese PLA General Hospital from January 5,2018 to October 26,2021 were selected as the research objects.According to the different indwelling time of nasogastric tube,they were divided into control group(n=100,with 30 days of indwelling time),experimental group A(n=50,with 30-60 days of indwelling time)and experimental group B(n=50,with 60-90 days of indwelling time).The hardness,color and rebound elasticity of the front end of the nasogastric tube after its removal were observed.And the damage of nasopharyngeal mucosa was evaluated by observing its color during the indwelling of nasogastric tube.Results Comparison of the front end of the nasogastric tubes after their removal showed that there was no significant difference in their proportion of hardness in different ranges among the three groups(χ^(2)=0.36,P>0.05),there was no significant difference in the proportion of color darkening among the three groups(χ^(2)=1.62,P>0.05),there was no significant difference in the proportion of rebound angle in the range of different rebound angles among the three groups(χ^(2)=0.73,P>0.05).And there was no significant difference in the damage of nasopharyngeal mucosa among the three groups(χ^(2)=0.36,P>0.05).Conclusion It is safe to prolong the indwelling time of polyurethane nasogastric tube in elderly patients to 90days,which reduces the mechanical damage caused by frequent replacement of nasogastric tube.