改良体位在ICU人工气道患者留置胃管中的应用
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摘要
目的探讨改良体位(抬颌仰额)加导丝引导置管法在ICU人工气道患者留置胃管中的应用效果。方法将实施人工气道的180例ICU住院患者按留置胃管顺序奇偶数分为对照组和观察组各90例,对照组采用常规体位加导丝引导置管法留置胃管,观察组采用改良体位加导丝引导置管法,观察两组一次性置管成功率、置管时间的差异。结果观察组留置胃管一次性置管成功率显著高于对照组、置管时间显著短于对照组(均P<0.01)。结论采用抬颌仰额位加导丝引导置管法能有效提高ICU人工气道患者留置胃管一次性置管成功率,缩短置管时间,进而减轻对患者食管损伤,提高护士工作效率。
Objective To explore the effect of improved positioning(head-till chin lift maneuver)and guide wire on placement of indwelling gastric tubes in patients with artificial airway.Methods Totally 180 patients with artificial airway in ICU were randomly divided into an observation group(n=90)and a control group(n=90).In the control group,the gastric tubes were placed in conventional posture with guide wire,while in the observation group,tubes were inserted with improved positioning(head-till chin lift maneuver)and guide wire.The one-time success rate of catheter placement and the time spent were compared between the two groups.Results The one-time success rate of catheter placement in the observation group was significantly higher than the control group,but the time spent in the former was significantly shorter than the latter(P<0.01 for both).Conclusion The improved positioning and guide wire can improve the success rate of catheter placement at first try and shorten the time spent,which can alleviate the injury to patients′esophagus and promote the efficiency of nursing staff.
Objective To explore the effect of improved positioning(head-till chin lift maneuver)and guide wire on placement of indwelling gastric tubes in patients with artificial airway.Methods Totally 180 patients with artificial airway in ICU were randomly divided into an observation group(n=90)and a control group(n=90).In the control group,the gastric tubes were placed in conventional posture with guide wire,while in the observation group,tubes were inserted with improved positioning(head-till chin lift maneuver)and guide wire.The one-time success rate of catheter placement and the time spent were compared between the two groups.Results The one-time success rate of catheter placement in the observation group was significantly higher than the control group,but the time spent in the former was significantly shorter than the latter(P<0.01 for both).Conclusion The improved positioning and guide wire can improve the success rate of catheter placement at first try and shorten the time spent,which can alleviate the injury to patients′esophagus and promote the efficiency of nursing staff.
引文
[1]孙四美,夏丽,薛辉.ICU气管插管患者留置胃管的方法研究[J].齐鲁护理杂志,2014,20(8):19-20.
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[4]黄秋萍,卢莉红.难置性胃管置入方法的临床研究[J].中国实用护理杂志,2004,20(11):60-61.
[5]温雅丽,高燕,王松.经鼻气管插管患者胃管置入中常见问题及对策[J].护理学杂志,2005,20(1):37.
[6]王荃,吴利群,李静.高龄机械通气患者留置鼻饲管方法探讨[J].护士进修杂志,2009,24(4):759-760.
[7]陈金素,李伟.56例气管切开患者留置胃管的方法与护理体会[J].医学理论与实践,2013,26(7):947-948.
[8]柏树令,应大君.系统解剖学[M].北京:人民卫生出版社,2008:385-386.
[9]王健本.实用解剖与解剖法[M].北京:人民卫生出版社,1985:13-61.
[10]葛媛璟.常用胃管固定方法及进展[J].齐齐哈尔医学院学报,2013,34(9):1346-1347.
[11]王海燕,胡亚玲.持续昏迷患者胃食道返流的医源性危险因素研究[J].中华急诊医学杂志,2013,22(3):315-317.
[12]王志琴.重型颅脑损伤行气管切开患者鼻饲返流的护理干预[J].齐齐哈尔医学院学报,2012,33(23):3294-3295.
[2]蔡燕颜.改良留置管方法在意识障碍患者中的应用与效果[J].护理实践与研究,2008,5(10):12-13.
[3]邱丽越,施丽旋.导丝辅助胃管置入法在ICU中的临床应用[J].福建医药杂志,2007,29(1):166.
[4]黄秋萍,卢莉红.难置性胃管置入方法的临床研究[J].中国实用护理杂志,2004,20(11):60-61.
[5]温雅丽,高燕,王松.经鼻气管插管患者胃管置入中常见问题及对策[J].护理学杂志,2005,20(1):37.
[6]王荃,吴利群,李静.高龄机械通气患者留置鼻饲管方法探讨[J].护士进修杂志,2009,24(4):759-760.
[7]陈金素,李伟.56例气管切开患者留置胃管的方法与护理体会[J].医学理论与实践,2013,26(7):947-948.
[8]柏树令,应大君.系统解剖学[M].北京:人民卫生出版社,2008:385-386.
[9]王健本.实用解剖与解剖法[M].北京:人民卫生出版社,1985:13-61.
[10]葛媛璟.常用胃管固定方法及进展[J].齐齐哈尔医学院学报,2013,34(9):1346-1347.
[11]王海燕,胡亚玲.持续昏迷患者胃食道返流的医源性危险因素研究[J].中华急诊医学杂志,2013,22(3):315-317.
[12]王志琴.重型颅脑损伤行气管切开患者鼻饲返流的护理干预[J].齐齐哈尔医学院学报,2012,33(23):3294-3295.