摘要
目的评价多导丝置管法床边盲插鼻肠喂养管的有效性、安全性。方法为39例住院患者行多导丝法盲插鼻肠喂养管44次。该方法在鼻肠管腔内预置三条导丝以增加刚度。置管时保持轻柔推力,随患者呼吸缓慢进管;如遇阻力增加或阻力突然消失,退管后重新进管。最后行美蓝回抽试验及床边X线造影腹部摄片明确管端位置。结果置管成功率为95%。2次置管失败改在X线透视下成功置管。无呼吸道内置管或消化道穿孔等并发症。结论多导丝置管法床边盲插鼻肠喂养管是成功率高、安全的置管方法。
Objective To evaluate the efficacy and safety of the multi-stylet method for bedside blind placement of nasoenteral feeding tubes.Methods Forty-four nasoenteral feeding tubes were placed at the bedside using the multi-stylet method in39patients requiring enteral nutrition support.Fifteen minutes after an IV infusion of250mg erythromycin lactobionate,a10F nonweighted,polyurethane nasoenteral feeding tube was introduced blindly.Three stylets were placed in the tube for stiffening.The tube was simply advanced with gentle force as the patient took breaths.A continuous low-grade resistance was normally encountered during the tube advancement.However,if the resistance was increased or lost suddenly,the tube was backed up and advanced forward again.Tip location was checked by injection of methylene blue and bedside abdominal roentgenography with contrast.Results Forty-two feeding tubes were positioned distal to the second portion of the duodenum,resulting in a95%success rate,with31feeding tubes(70%)placed into proximal jejunum.The average time for tube placement was(26±14)minutes.No inadvertent respiratory placement of feeding tubes or perforation of the GI tract occurred.Conclusions The multi-stylet method for bedside blind placement of nasoenteral feeding tubes is an efficient and safe technique with a high success rate.
出处
《中国临床营养杂志》
2002年第3期191-194,共4页
Chinese Journal of Clinical Nutrition
关键词
危重病
肠营养
吸入性肺炎
鼻肠管
critical illness
enteral nutrition
aspiration pneumonia
nasoenteral tube
