改良型鼻肠管在重型颅脑损伤患者中运用效果分析

Analysis of application effect of modified-type nasojejunal tube in severe traumatic brain injury

目的：探讨改良型鼻肠管在重型颅脑损伤患者早期肠内营养中的应用及其效果。方法选取神经外科病房符合纳入标准的患者60例，按照随机数字表法随机分为对照组和试验组，每组30例，对照组留置正常螺旋型鼻肠管，试验组留置改良型鼻肠管。比较2组置管成功率、2组置管操作时间、胃瘫恢复时间等。结果试验组置管成功率为93.3%（28/30），对照组为73.3%（22/30），2组比较差异有统计学意义（χ2=4.320，P＜0.05）。试验组置管操作时间为（22.67±1.77）min，对照组为（28.90±3.39）min，2组比较差异有统计学意义（t=8.936，P＜0.05）。试验组胃瘫恢复时间为（17.37±8.29）d，对照组为（21.60±7.82）d，2组比较差异有统计学意义（t=2.035，P＜0.05）。2组使用前后格拉斯哥昏迷量表（GCS）评分比较差异无统计学意义（P＞0.05）。试验组患者或家属满意率为93.3%（28/30），对照组为60.0%（18/30），2组比较差异有统计学意义（χ2=9.317，P＜0.05）。结论改良螺旋型鼻肠管能够提高置管成功率。重型颅脑损伤合并胃瘫的患者使用改良型鼻肠管胃瘫症状恢复较早。改良型鼻肠管操作简单方便，适合初学者及年轻护士，患者或家属满意度较高。

Objective To explore the application and effect of modified-type nasojejunal tube of early enteral nutrition in severe traumatic brain injury patients. Methods 60 sever brain injury patients were collected in the neurosurgery ward of our hospital. The patients were divided into control group and trial group by random number table. The patients in control group were treated with normal spiral nasojejunal tube, and the patients in trail group were given modified-type nasojejunal tube. The study mainly researched the success rate of intubation, the operation time of two groups, the recovery time of gastropareaia and so on. Results The success rate of intubation of experimental group was 93.3%(28/30) which was significantly higher than 73.3% (22/30) in the control group (χ2=4.320, P<0.05). The operation time of two groups were (22.67±1.77) minutes and (28.90±3.39) minutes. The operation time of two groups had significant difference (t=8.936, P<0.05).The recovery time of gastropareaia of two groups were (17.37 ± 8.29) days and (21.60 ± 7.82) days. The recovery time of gastropareaia of two groups had significant difference between two groups (t=2.035, P<0.05). There was no satistically significant difference of Glasgow Coma Scale (GCS) score between two groups (P>0.05). The satisfaction of patient or family of experimental group was 93.3%(28/30) which was significantly higher than 60.0%(18/30) of the control group (χ2=9.317, P<0.05). Conclusions The modified-type nasojejunal tube was conducive to improve the success rate of intubation. The symptoms of gastroparesis were recovered early. The modified-type nasojejunal tube was easy operation, suitable for beginners and young nurses. The satisfaction of patient or family was higher.