摘要
目的 :观察呼气末二氧化碳分压(End-Tidal Carbon Dioxide Partial Pressure,PETCO2)监测在指导昏迷患者留置胃管过程中的应用效果。方法 :采用便利抽样法选择2019年1-8月在某三级甲等医院急诊ICU就诊的44例昏迷患者为研究对象,编号后按单号、对号分为对照组与干预组各22例。对照组采用传统盲插方式进行胃管置入,干预组在PETCO2监测下进行胃管置入,比较两种操作方法的置管时间、一次性置管成功率、血流动力学变化及不良反应发生率。结果 :44例患者均完成留置胃管操作。干预组留置胃管耗时[(4.87±1.03) min]比对照组[(7.22±2.51)min]短(P<0.05),干预组一次性置管成功率(63.64%)比对照组(50.00%)高。干预组患者在插胃管过程中心率、呼吸、血氧饱和度、平均动脉压的变化波动值比对照组小,差异有统计学意义(P<0.05)。干预组患者呛咳、恶心呕吐发生率(4.55%,13.64%)低于对照组(31.82%,45.45%)(P<0.05)。结论 :在PETCO2监测下对昏迷患者进行胃管的置入,不仅能减少对患者的不良刺激,还能及时有效地判断胃管位置,从而指导护士插管,提高效率,减少隐患。
Objective: To examine the effect of End-Tidal Carbon Dioxide Partial Pressure(PETCO2) monitoring in indwelling gastric tube of comatose patients. Methods: Following convenient sampling, a totall of 44 comatose patients in the Emergency Intensive Care Unit were enrolled in the study, and they were equally divided into control group(n=22) and intervention group(n=22). In the control group, the gastric tubes were placed in the traditional way. In the intervention group, the gastric tubes were implanted under the monitoring of PETCO2. The time spent on indwelling a gastric tube, the one-time intubation success rate, hemodynamic changes and incidence of adverse reactions were compared between the two methods. Results: All 44 patients were successfully intubated with the indwelling gastric tubes. The time spent on indwelling a gastric tube in the intervention group [(4.87±1.03) min] was shorter than that in the control group [(7.22±2.51) min](P<0.05), and the one-time intubation success rate of the intervention group(63.64%) was higher than that of the control group(50.00%). The fluctuation values of heart rate, respiration, blood oxygen saturation, and mean arterial pressure in the intervention group during gastric tube intubation were smaller than those in the control group, and the difference was statistically significant(P<0.05). The incidence of coughing, nausea and vomiting in the intervention group(4.55%, 13.64%) was lower than that in the control group(31.82%, 45.45%)(P<0.05). Conclusion: According to our results, the placement of the gastric tube in comatose patients with PETCO2 monitoring can not only reduce possible adverse stimulation, but also can efficiently and effectively assist nurses to determine the positioning of a gastric tube. Thus, the placement of the gastric tube in comatose patients with PETCO2 monitoring could improve the work efficiency of nurses and reduce complications.
作者
藏瑞
张艳
温亚
ZANG Rui;ZHANG Yan;WEN Ya(Emergency Department,The Second Hospital of Shanxi Medical University,Taiyuan,030001,China;不详)
出处
《中国护理管理》
CSCD
2021年第2期307-310,共4页
Chinese Nursing Management
基金
山西省重点研发计划项目(201903D321017)。
关键词
呼气末二氧化碳分压
监测
昏迷患者
留置胃管
End-Tidal Carbon Dioxide Partial Pressure
monitoring
comatose patients
indwelling gastric tube
