电磁导航床旁鼻肠管置管技术在老年卧床患者中的应用

Application of electromagnetic-guided placement of nasoenteral feeding tubes among aged bedridden patients

目的探讨电磁导航床旁鼻肠管置管技术在老年卧床患者中的应用效果。方法采用便利抽样法,选取2021年6月—2022年12月北京市某三级甲等医院收治的92例老年卧床管饲患者作为应用对象,采用随机数字表法将其分为试验组和对照组各46例。试验组采用电磁导航床旁鼻肠管置管技术留置鼻肠管,对照组采用盲插法留置鼻肠管,比较两组的总置管成功率、一次置管成功率、置管用时、导管尖端到达空肠的比例、置管相关并发症发生率。结果两组均无脱落病例。试验组总置管成功率为95.7%,对照组为80.4%;试验组一次置管成功率为95.7%,对照组为71.7%;试验组置管用时为(12.37±4.19)min,对照组为(19.22±5.48)min;试验组导管尖端到达空肠的比例为60.9%,对照组为28.3%。以上数据两组比较,差异均具有统计学意义(P<0.05)。在置管相关并发症发生率方面,试验组鼻出血发生率为6.5%,对照组为21.7%,两组比较,差异具有统计意义(P=0.036);试验组便潜血试验阳性发生率为2.2%,对照组为17.4%,两组比较,差异具有统计意义(P=0.030);两组恶心呕吐、腹胀发生率比较,差异无统计学意义(P>0.05);两组均未发生导管异位、气胸、穿孔等并发症。结论采用电磁导航床旁鼻肠管置管技术为老年卧床患者留置鼻肠管的成功率高,用时短,可提升导管尖端到达空肠的比例,降低鼻出血、便潜血试验阳性发生率。

Objective To investigate the application effect of electromagnetic navigation bedside nasoenteral intubation technology in elderly bedridden patients.Methods A total of 92 elderly patients with tube feeding in bed in a tertiary A hospital in Beijing from June 2021 to December 2022 were selected by convenience sampling method,and they were divided into an experimental group and a control group with 46 patients in each group by random number table method.The experimental group adopted the electromagnetic navigation bedside nasoenteral catheterization technique and the control group adopted the blind catheterization method.The total success rate of catheterization,the success rate of the first catheterization,the time taken for catheterization,the proportion of catheter tip reaching jejunum,and the incidence of catheter-related complications were compared between the 2 groups.Results There were no shedding cases in both groups.The success rate of total catheterization was 95.7%in the experimental group and 80.4%in the control group.The success rate of first catheterization was 95.7%in the experimental group and 71.7%in the control group.The time taken for catheterization was(12.37±4.19)min in the experimental group and(19.22±5.48)min in the control group.The proportion of catheter tip reaching the jejunum was 60.9%in the experimental group and 28.3%in the control group.The above data were compared between the 2 groups,and the differences were statistically significant(P<0.05).In terms of the incidence of catheter-related complications,the incidence of epistaxis in the experimental group was 6.5%and it was 21.7%in the control group,and the difference was statistically significant(P=0.036).The positive rate of fecal occult blood test was 2.2%in the experimental group and 17.4%in the control group,and the difference was statistically significant(P=0.030).There was no significant difference in the incidence of nausea,vomiting and abdominal distension between the 2 groups(P>0.05).No serious complications such as catheter ectopic placement,pneumothorax and perforation occurred in the 2 groups.Conclusion The application of electromagnetic navigation bedside nasoenteral intubation technology for elderly bedridden patients has a high success rate and takes a short time,which can improve the proportion of catheter tip reaching the jejunum and reduce the incidence of epistaxis and fecal occult blood test.