基于正交试验的肾造瘘管固定方案研究

Determination of fixation plan for nephrostomy tube through orthogonal design

目的探讨基于正交试验的肾造瘘管不同固定方案的比较效果。方法将14Fr硅胶肾造瘘管固定在聚乙烯展板和拉力显示器上,以固定材料、固定方法、面积为3个影响因素,每个因素3个水平,每组进行3次试验再求平均值作为最后拉力值F,共进行9个固定方案共27次试验。利用L_(9)(3^(3))正交试验矩阵研究不同材料(医用橡皮膏、医用透气胶带、医用无纺布胶带)、固定方法(交叉固定法、“工”字固定法和改良“工”字固定法)及面积(16 cm^(2)、24 cm^(2)、32 cm^(2))对肾造瘘管固定强度的影响。结果正交试验所选的3种影响因素中,对拉力值影响显著性排序为:材料>方法>面积;3种固定材料中,医用橡皮膏固定强度最大。结论肾造瘘管固定方案中,最佳固定组合为以医用橡皮膏结合改良“工”字法固定,可为临床管道固定方案的选择提供参考。

Objective To compare the effect of various methods for securing a nephrostomy tube through a orthogonal design.Methods One end of a 14 Fr silicone nephrostomy tube was fixed on the polyethylene display board,and the other end on the display force card.The fixation material,fixation method and area were seen as 3 influencing factors,and each factor had 3 levels.Three experiments were conducted in each group(factor)and the average value of pulling forces was calculated as the final tension value F.A total of 27 experiments were conducted in 9 fixation schemes.L_(9)(3^(3))orthogonal experimental matrix was used to study the effects of different materials(medical adhesive paste,medical breathable tape,medical non-woven tape),fixation methods(cross fixation,I-shaped fixing method,modified I-shaped fixing method)and fixation areas(16 cm^(2),24 cm^(2),32 cm^(2))on the fixation strength of the nephrostomy tube.Results Among the 3 factors selected in the orthogonal experiment,the order of significance in terms of tension value was:material>method>area;among the three kinds of fixation materials,medical adhesive paste had the highest fixation strength.Conclusion The best fixation plan for a nephrostomy tube is to use medical adhesive paste and modified I-shaped fixation method.This could provide a reference for selection of tube fixation scheme in clinical settings.