电磁导航鼻肠管置入技术在神经外科重症患者中的应用

Application of electromagnetic navigation nasointestinal tube insertion technology to critically ill neurosurgical patients

目的观察电磁导航鼻肠管置入技术在神经外科重症患者中的应用效果。方法采用便利抽样法,选取2023年1月至2023年12月解放军总医院第一医学中心收治的60例神经外科重症患者,采用随机数字表法将其分为试验组和对照组各30例。试验组采用电磁导航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、置管相关不良事件的发生情况,分析并比较两组干预前、干预10 d后营养指标[血红蛋白(Hb)、血清白蛋白(Alb)]。结果试验组总置管成功率为96.7%,对照组为80.0%;试验组一次置管成功率为93.33%,对照组为73.33%;试验组置管用时为(16.20±5.65)min,对照组为(34.13±13.60)min;以上数据两组比较,差异均具有统计学意义(P<0.05)。在置管相关不良事件发生方面,试验组鼻黏膜出血1例、呛咳1例,对照组鼻黏膜出血4例、呛咳5例、恶心呕吐3例,两组比较,差异具有统计意义(P=0.036);两组均未发生气胸、穿孔、消化道出血等并发症。在营养指标方面,两组患者比较置管后10 d营养指标改善情况无统计学差异,试验组患者置管前后营养指标差异有统计学意义(P<0.05)。结论采用电磁导航鼻肠管置管技术为神经外科重症患者留置鼻肠管的成功率高,操作用时短,能够为神经外科重症患者提供早期营养支持,且置管相关不良事件的发生率较低。

Objective To observe the application effects of electromagnetic navigation nasointestinal tube implantation to critically ill neurosurgical patients.Methods A total of 60 patients with severe neurosurgical conditions admitted to a GradeⅢA hospital in Beijing from January 2023 to December 2023 were selected by convenience sampling method,and randomly divided into the experimental group and the control group with 30 patients in each group.The experimental group was treated with electromagnetic navigation nasointestinal tube insertion technology and the control group was treated with blind catheterization.The total success rate of catheterization,the success rate of once-only catheterization,the occurrence of catheterization-related adverse events in the two groups were compared,and the nutritional indexes(hemoglobin(Hb)and serum albumin(Alb))before intervention and 10 days after intervention were compared and analyzed.Results The total success rate of catheterization was 96.7%in experimental group and 80%in control group.The success rate of once-only catheterization was 93.33%in experimental group and 73.33%in control group.The duration of catheterization was(16.20±5.65)min for the experimental group and(34.13±13.60)min for the control group.The differences between the two groups were statistically significant(P<0.05).In terms of adverse events related to catheterization,the incidence of nasal mucosal hemorrhage in the experimental group was 1 case,cough in 1 case,whereas the incidence of nasal mucosal hemorrhage in the control group was 4 cases,cough in 5 cases,nausea and vomiting in 3 cases,and the difference was statistically significant(P=0.036),and no complications such as pneumothorax,perforation and gastrointestinal bleeding occurred in the two groups.In terms of nutritional indexes,there was no statistically significant difference in the improvement of nutritional indexes at 10 days after catheterization between the two groups,but the difference in nutritional indexes before and after catheterization in the experimental group was statistically significant(P<0.05).Conclusion The application of electromagnetic navigation nasointestinal tube insertion technology in critically ill neurosurgical patients has a higher success rate,shorter operation time,lower rate of catheter-related adverse events incidence,and can provide early nutritional support for critically ill neurosurgical patients.