利多卡因凝胶在重症监护病房清醒患者床旁盲置空肠营养管中的应用

Application of lidocaine gel in bedside blind placement of jejunal nutrition tube for conscious patients in ICU

目的 探讨利多卡因凝胶在重症监护病房清醒患者床旁盲置空肠营养管中的临床应用价值。方法 将2021年6月至2022年8月该院需要安置营养管的82例清醒患者按置管时间排序,采用信封法随机分组,奇数为对照组,偶数为观察组,每组41例。对照组予石蜡油润滑置管侧鼻腔及管道,观察组置管侧鼻腔在操作前10 min予利多卡因凝胶滴鼻,予利多卡因凝胶润滑管道,然后按照盲置营养管的方法置入管道,营养管前端插到十二指肠或空肠上段,比较2组患者置管成功率、置管时间、对置管刺激的反应程度。结果 2组患者置管成功率比较,差异无统计学意义(P>0.05);与对照组比较,观察组置管成功所需时间更短,患者对置管刺激的反应程度更低,差异均有统计学意义(P<0.05)。结论 在患者清醒的状态下,应用利多卡因凝胶辅助床旁盲置空肠营养管是一种操作简单、安全、经济、有效的方法。

Objective To explore the clinical application value of lidocaine gel in bedside blind placement of jejunal nutrition tube in conscious patients in Intensive Care Unit(ICU).Methods From June 2021 to August 2022,a total of 82 conscious patients who needed to be placed with nutrition tube in this hospital were sorted according to the time of catheterization.They were randomly divided into the control group(odd number)and the experimental group(even number)by envelope method,with 41 cases in each group.The control group was given paraffin oil to lubricate the nasal cavity and pipeline on the catheterization side.The nasal cavity of the catheterization side in the experimental group was given lidocaine gel nasal drip 10 minutes before operation,and lidocaine gel was given to lubricate the pipeline.Then the pipeline was placed according to the method of blind placement of nutrition tube,and the front end of the nutrition tube was inserted into the upper segment of duodenum or jejunum.The success rate of catheterization,catheterization time and the degree of response to catheterization stimulation were compared between the two groups.Results There was no significant difference in the success rate of catheterization between the two groups(P>0.05).Compared with the control group,the time required for successful catheterization in the experimental group was shorter,and the patients′response to catheterization stimulation was lower,with statistical significance(P<0.05).Conclusion In the awake state of patients,the application of lidocaine gel assisted bedside blind jejunal nutrition tube is a simple,safe,economical and effective method.