摘要
目的:设计一种依托鼻中隔为支撑的鼻胃管内固定新技术,验证该技术操作的可行性、安全性与固定效果。方法:选取2022年3月至2023年9月在四川省肿瘤医院接受经鼻留置胃管的肿瘤患者。使用信封进行抽签,对入组的患者进行简单随机分组。内固定组采用以鼻中隔为支撑的内固定技术固定留置胃管,外固定组采用传统胶布外固定法。收集并比较固定胃管操作时不良反应和操作时间;留置期间的胃管固定效果、不良反应、患者体验感、护理时间等各研究指标的数据资料,分析鼻胃管内固定技术的临床应用价值。结果:本研究共纳入91例患者,其中内固定组48例,外固定组43例。两组比较,胃管固定时操作时间和操作不良反应,外固定组优于内固定组,差异均有统计学意义(Z=41.500,P<0.001;χ^(2)=11.209,P=0.004),鼻胃管留置期间固定效果的脱出率、不良反应、护理时间成本的固定频次及维护总时间,内固定组优于外固定组,差异均有统计学意义(χ^(2)=5.906,P=0.015;χ^(2)=9.220,P=0.027;Z=-45.884,P<0.001;Z=-20.045,P<0.001);自我感觉体验的皮肤易清洁程度、舒适度和满意度,内固定组优于外固定组,差异均有统计学意义(χ^(2)=53.835,P<0.001;χ^(2)=34.326,P<0.001;χ^(2)=4.670,P=0.031)。结论:本研究设计的鼻胃管内固定术借鉴和使用了临床已有的方法和材料,未额外增加患者费用支出,同时解决了鼻胃管依赖外固定带来的脱管、维护操作费时、皮肤损伤等问题,操作安全且留置期间不良反应少,具有临床推广价值。
Objective:To design a nasal septum-supported nasogastric tube securement technique and verify its feasibility,safety,and securement efficacy.Methods:Patients admitted to Sichuan Cancer Hospital between March 2022 and September 2023 were enrolled.Using sealed envelopes for randomization,enrolled patients were allocated through simple random sampling.The internal securement group received nasogastric tube fixation using a septal-supported internal securement technique,while the external securement group underwent conventional external taping method.Adverse reactions and procedure time associated with gastric tube securement were recorded and compared between groups.Data on in-situ stability of gastric tubes,adverse reactions,patient-reported experience measures,and nursing time expenditure during indwelling periods were analyzed to evaluate the clinical utility of nasogastric tube internal securement techniques.Results:Ultimately,91 patients completed the study and were included in the final analysis:48 in the internal securement group and 43 in the external securement group.Compared with the internal securement group,the external securement group demonstrated shorter procedure time and fewer adverse reactions during gastric tube securement,with statistically significant differences(Z=41.500,P<0.001;χ^(2)=11.209,P=0.004).The internal securement group demonstrated superior outcomes in tube dislodgement rates,adverse reactions,per-securement nursing time,and total maintenance time during nasogastric tube indwelling compared to the external securement group,with statistically significant differences(χ^(2)=5.906,P=0.015;χ^(2)=9.220,P=0.027;Z=-45.884,P<0.001;Z=-20.045,P<0.001).The internal securement group demonstrated significantly superior patient-reported outcomes in skin cleanability,comfort level,and overall satisfaction compared to the external securement group,with statistically significant differences(χ^(2)=53.835,P<0.001;χ^(2)=34.326,P<0.001;χ^(2)=4.670,P=0.031).Conclusion:This study refines an endoscopic-assisted nasogastric tube securement technique utilizing established clinical methodologies and materials,eliminating supplementary patient expenses.The approach resolves complications inherent to external fixation-including tube displacement,time-consuming maintenance procedures,and skin injuries-while demonstrating proce-dural safety and low adverse event rates during indwelling periods,indicating significant clinical applicability and implemen-tation potential.
作者
唐媛
谯丹
张燕
侯颜佳
赖显洪
周梓轩
朱科第
唐小丽
王朝晖
王国蓉
张甜
Tang Yuan;Qiao Dan;Zhang Yan;Hou Yanjia;Lai Xianhong;Zhou Zixuan;Zhu Kedi;Tang Xiaoli;Wang Zhaohui;Wang Guorong;Zhang Tian(Department of Neurosurgery,Sichuan Clinical Research Center for Cancer,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China;Department of Head and Neck-Otolaryngology,Sichuan Clinical Research Center for Cancer,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China;Department of Comprehensive VIP Medical Services,Sichuan Clinical Research Center for Cancer,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China;Department of Nursing,Sichuan Clinical Research Center for Cancer,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China;Department of Nursing,West China School of Public Health/West China Fourth Hospital of Sichuan University,Chengdu 610041,Sichuan,China)
出处
《肿瘤预防与治疗》
2025年第8期688-695,共8页
Journal of Cancer Control And Treatment
基金
2021年四川省干部保健科研课题(编号:[川干研]2021-807)
四川省医学会青年创新课题(编号:Q2024050)。
关键词
鼻胃管
内固定技术
固定效果
不良反应
护理
Nasogastric tube
Catheter securement technique
Securement efficacy
Adverse reactions
Nursing
