咽胃一体管在机械通气重症胰腺炎患者中的运用与护理
| 作者: |
1张德芬,
1陈妮,
1周成莉,
2毛世芳
1 西南医科大学附属医院急诊医学部，四川 泸州 646000 2 西南医科大学附属医院护理部，四川 泸州 646000 |
| 通讯: |
毛世芳
Email: 1172058534@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2019.06.022 |
| 基金: | 西南医科大学应用基础研究项目 (2015-YJ083)；西南医科大学附属医院护理研究项目 (2015-HL-016)。 |
摘要
目的：探讨新型胃管“咽胃一体管”在需机械通气并安置胃管的重症急性胰腺炎(severe ac ute pancreatitis，SAP)患者中的应用价值。方法：选取2016年7月至2018年3月西南医科大学附属医院急诊医学部收治的SAP患者60例为研究对象。采取前瞻性病例对照研究方法，随机将患者分为观察组与对照组，其中观察组安置新型咽胃一体管，对照组安置传统胃管，两组患者均给予常规治疗手段和护理措施。比较两组患者呼吸机相关肺炎发生率、管道并发症发生率、痰液引流量、CRP、降钙素原等指标。结果：观察组呼吸机相关性肺炎发生率较对照组降低，且差异有统计学意义( P<0.05)；观察组导管并发症发生率较对照组降低，但差异无统计学意义( P> 0.05)。置管后1周，观察组引流、吸引痰液总量显著高于对照组；置管后第7天开始，两组痰液量均有减少趋势，观察组降低更为显著( P< 0.05)。比较两组血清CRP水平，治疗后 1周，观察组CRP水平显著低于对照组(P<0.01)；治疗后第2周，两组比较差异无统计学意义；对照组血清降钙素原水平于治疗后1周、2周显著升高，均高于观察组，差异有统计学意义(P<0.05)。 结论：应用咽胃一体管可显著减少SAP患者呼吸机相关性肺炎的发生率，并可提高痰液引流效率，降低感染性指标，有一定的临床应用前景。
关键词：
留置胃管；机械通气；重症胰腺炎；护理；咽胃一体管
Application and nursing of integrated pharyngeal and gastric tubes in patients with severe acute pancreatitis with mechanical ventilation
CorrespondingAuthor: MAO Shifang Email: 1172058534@qq.com
DOI: 10.3978/j.issn.2095-6959.2019.06.022
Foundation: This work was supported by the Applied Basic Research Project of Southwest Medical University (2015-YJ083) and Nursing Research Project of Affiliated Hospital of Southwest Medical University (2015-HL-016), China.
Abstract
Objective: To discuss our self-developed a new type of gastric tube—integrated pharyngeal and gastric tubes, put the tube in mechanical ventilation and the application of the patients with severe acute pancreatitis value selection. Methods: A total of 60 cases of severe acute pancreatitis admitted to the Emergency Department of Affiliated Hospital of Southwest Medical University from July 2016 to March 2018 were selected as the research objects. Patients were randomly divided into an observation group and a control group. The observation group put new gastric tube, and the control group placed traditional gastric tube. Two groups of patients were given routine therapy and nursing measures to compare two groups of patients with ventilator associated pneumonia duct complications incidence of sputum of CRP, procalcitonin and other indicators. Results: The incidence of ventilator-associated pneumonia in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). The incidence of catheter complications in the observation group was lower than that in the control group, but the difference was not significant (P>0.05). One week after catheterization, the amount of sputum drainage and suction in the observation group was significantly higher than that in the control group. From the 7th day after catheterization, the amount of sputum in both groups showed a decreasing trend, and the decrease was more significant in the observation group (P<0.05). Serum CRP levels in the two groups were compared. One week after treatment, CRP levels in the observation group were significantly lower than those in the control group (P<0.01). The serum PCT level of the control group was significantly increased at 1 and 2 weeks after treatment, both higher than that of the observation group, with statistical difference (P<0.05). Conclusion: The application of integrated pharyngeal and gastric tubes can significantly reduce the incidence of ventilator-associated pneumonia in patients with severe acute pancreatitis, improve the sputum drainage flow, reduce the infectious index, and has a certain prospect of clinical application.
Keywords：
gastric intubation; mechanical ventilation; severe acute pancreatitis; nursing; integrated pharyngeal and gastric tubes