[1]张 敏,陆素英,韩小云,等.集成实时成像技术在成人危重症病人鼻肠管置管中的应用研究[J].肠外与肠内营养杂志,2023,(06):357-362.[doi:DOI : 10.16151/j.1007-810x.2023.06.007]
　ZHANG Min,LU Su-ying,HAN Xiao-yun,et al.A study on the application of integrated real-time imaging in nasoenterictube placement in adult critically ill patients[J].PARENTERAL & ENTERAL NUTRITION,2023,(06):357-362.[doi:DOI : 10.16151/j.1007-810x.2023.06.007]
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集成实时成像技术在成人危重症病人鼻肠管置管中的应用研究()
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2023年06期
页码:
357-362
栏目:
论著
出版日期:
2023-12-10

文章信息/Info

Title:
A study on the application of integrated real-time imaging in nasoenterictube placement in adult critically ill patients
作者:
张 敏 1; 陆素英 1; 韩小云 2; 吴智水 2; 杨 靖 1; 陈建芬 1; 郑 峰 3
常州市第一人民医院，1.重症医学科；2.护理部，3. 医务科，江苏常州 213000
Author(s):
ZHANG Min1;  LU Su-ying1;  HAN Xiao-yun2;  WU Zhi-shui2;  YANG Jing1;  CHEN Jian-fen1; ZHENG Feng3
A study on the application of integrated real-time imaging in nasoenterictube placement in adult critically ill patients
关键词:
可视化 ; 鼻肠管 ; 置管 ; 重症病人 ; 肠内营养
Keywords:
Visualization;  Nasoenteric tube;  Tube placement;  Critically ill patients;  Enteral nutrition
分类号:
R473，R459.3
DOI:
DOI : 10.16151/j.1007-810x.2023.06.007
文献标志码:
A
摘要:
目的：探讨基于集成实时成像技术的床旁可视化鼻肠管置管用于成人危重病人的安全性及有效性。 方法：本研究为单中心随机对照研究，以 2022年 1月至 2022年 12月就诊于常州市第一人民重症医学科需要留置鼻肠管行肠内营养的危重病人为研究对象，按照计算机生成的随机序列将其分为试验组和对照组，试验组采用可视化鼻肠管置管，对照组采用床旁盲插鼻肠管置管，两组病人置管后均采用 X线腹部平片确认管道尖端位置，比较两组病人置管并发症（包括鼻黏膜出血、胃肠黏膜出血、误入病人气道、生命体征警报事件）的发生率、首次幽门后置管成功率、置管时间及 X线摄片符合率。 结果：共纳入 108例病人，试验组和对照组病人均为 54例，两组病人置管总并发症发生率分别为 16.67%、40.74%，其中误入病人气道发生率分别为，0、16.67%，首次幽门后置管成功率分别为 90.74%，59.26%，置管时间分别为(21.15 ± 18.16)min，(29.63 ± 17.29)min，差异均有统计学意义（P <0.05），试验组和对照组的 X线摄片符合率分别为 100%，88.89%，Kappa值分别为 1.000，0.770 。 结论：利用集成实时成像技术辅助危重病人床边可视化鼻肠管置管可降低置管总并发症发生率，尤其可降低误入病人气道的风险，提高首次幽门后置管成功率、缩短置管时间，且与 X线摄片符合率高，尤其适用于AGI分级 I级-III级的危重病人。
Abstract:
Objective: To investigate the safety and efficacy of bedside visualization of nasoenteric tubeplacement for adult critically ill patients based on integrated real-time imaging technology. Methods: The study was asingle-center randomized controlled study of critically ill patients who were admitted to the department of intensive careunit of the First People’s Hospital of Changzhou from January 2022 to December 2022, and who were in need t anasogastric tube for enteral nutrition, and who were randomly divided into experimental group and control groupaccording to the computer-generated random sequence. Visual nasogastric tube insertion based on integrated real-timeimaging system technology was used in the experimental group, while blind nasogastric tube insertion was used in thecontrol group.After tube placement, X-ray abdominal plain film was used to confirm the position of the tip of the tube,and the incidence of complications of tube placement (including nasal mucosal bleeding, gastrointestinal mucosalbleeding, accidental entry into the patient’s airway, and vital sign alarm events), the success rate of the first post-pylorictube placement, the time of tube placement, and the compliance rate of X-ray radiographs were compared between thetwo groups of patients. Results: A total of 108 patients were included, 54 patients in each group. The total complicationrates of intubation in the experimental group and control group was 16.67% vs 40.74%, of which the incidence rate of intubation was 0.00% vs 16.67%, respectively, and the success rate of posterior pyloric intubation was 90.74% vs59.26%, and the time of tube placement was (21.15 ± 18.16) min vs (29.63 ± 17.29) min, the differences werestatistically significant(P < 0.05).The compliance rates of radiographs in the experimental group and the control groupwere 100% vs 88.89%, and the kappa coefficient were 1.000 vs 0.770. Conclusion: The use of integrated real-timeimaging technology to assist bedside visual naso-intestinal intubation in critically ill patients can reduce the totalcomplication rate of tube placement, especially reduce the risk of inadvertent entry into the patient’s airway, improve thesuccess rate of post-pyloric intubation, shorten the intubation time, and have a high rate of conformity with X-rayradiographs, which is especially suitable for critically ill patients with AGI class I-III.

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备注/Memo

备注/Memo:
作者简介 ：张 敏，副主任护师，硕士研究生，主要从事危重症病人的护理研究。E-mail：382748723@qq.com通讯作者 ：陆素英，E-mail：93330038@qq.com
更新日期/Last Update: 1900-01-01