重型颅脑损伤患者盲插空肠营养管的可行性和安全性评价

发布时间：2019-03-26 09:59

【摘要】：目的:评价重型颅脑损伤患者床旁使用鼻胃管盲插置入空肠实施肠内营养的可行性和安全性。方法:选择2013年1月至2014年12月常州市第一人民医院神经外科收治的重症颅脑损伤患者126例,在床旁使用鼻胃管盲插置入空肠。观察置管的成功率、置管过程耗时、置管前后生命体征的改变、置管相关并发症的发生率和置管后实施肠内营养的时间。结果:126例患者成功置管115例,总置管成功率91.3%。置管过程耗时37(30,50)min。置管前后生命体征各参数比较差异无统计学意义(P0.05)。126例患者置管过程中未发生心律失常、出血、穿孔等置管相关的并发症。115例置管成功的患者,通过空肠营养管实施肠内营养的时间为37(27,54)d,均未发生堵管现象。结论:重型颅脑损伤患者盲插置入空肠营养管,置管成功率高,对生命体征无显著影响,不增加置管相关并发症的风险,留置导管肠内营养的时间能满足管道需要。该技术可行性和安全性较高,利于重症颅脑损伤患者早期肠内营养的实施。
[Abstract]:Objective: to evaluate the feasibility and safety of bedside nasogastric tube blind insertion into jejunum for enteral nutrition in patients with severe craniocerebral injury. Methods: 126 patients with severe craniocerebral injury treated by neurosurgery, Changzhou first people's Hospital from January 2013 to December 2014, were treated with blind insertion of nasogastric tube into jejunum. The success rate of catheterization, the time-consuming of catheterization, the changes of vital signs before and after catheterization, the incidence of complications associated with catheterization and the time to implement enteral nutrition after catheterization were observed. Results: of 126 cases, 115 cases were successfully catheterized, and the total success rate was 91.3%. The process takes 37 (30,50) min. There was no significant difference in vital signs before and after catheterization (P0.05). 126 patients had no complications related to catheter placement, such as arrhythmia, bleeding, perforation, etc. 115 patients had successful catheterization. The duration of enteral nutrition through jejunal nutrition tube was 37 (27, 54) days, and no blockage occurred. Conclusion: blind insertion of jejunal nutrition tube in patients with severe craniocerebral injury has a high success rate, has no significant effect on vital signs, does not increase the risk of complications associated with catheter placement, and the duration of indwelling catheter enteral nutrition can meet the needs of the catheter. This technique is feasible and safe, and it is beneficial to implement early enteral nutrition in patients with severe craniocerebral injury.
【作者单位】：江苏省常州市第一人民医院;
【分类号】：R651.15

【参考文献】