摘要
重症患者经小肠喂养可降低经胃喂养导致的肺炎发生、缩短ICU住院时间等,改善重症患者预后。盲插鼻肠管指不借助设备引导,徒手将小肠营养管经鼻插入十二指肠或空肠。盲插鼻肠管因无设备引导,插管成功率低,如何提高插管成功率、插管过程中如何在患者床边判断鼻肠管是否到达十二指肠或空肠,是目前研究的热点。本文结合近年来国内外相关研究,从插管方法和床边定位技术两个方面进行综述。文献复习结果表明,插管方法方面,间歇推进插管法与持续不间断插管法比较、胃内注入空气法与胃内注水法比较,何种方法的插管成功率更高需进一步研究;在使用促胃动力药物提高插管成功率时,要注意避免超剂量用药并观察药物的不良反应;床边定位技术方面,尚无较好的定位方法,需要探索一种操作简便、准确性较高的床边定位技术。未来需通过不断探索改进盲插鼻肠管插管技术和定位技术,使留置鼻肠管更加快捷、安全有效。
Small intestinal feeding in severe patients can reduce the incidence of pneumonia caused by gastric feeding and shorten the length of stay in ICU,so as to improve the prognosis of severe patients.Blind nasointestinal catheterization refers to the manual insertion of a nutrient tube through the nose into the duodenum or jejunum,without equipment guidance,so as to provide a way for severe patients to feed through the small intestine.Due to the lack of equipment to guide the insertion of nasointestinal tube,the success rate of intubation needs to be improved.How to improve the success rate of intubation,how to judge whether the nasointestinal tube reaches the duodenum or jejunum at the patient's bedside during intubation,are the hot issues of current research.This article reviews the methods of nasointestinal tube insertion and bedside localization technology based on the domestic and foreign literature in recent years.The results of literature review indicate that further studies are needed to compare intermittent intubation with continuous intubation,gastric air infusion with gastric water infusion,and which method has a higher success rate of intubation.When using gastrointestinal motility drugs to improve the success rate of intubation,attention should be paid to avoid over dosage of drugs and observe the adverse reactions of drugs.Bedside localization technologystill needs to continuously explore a set of simple and high accuracy bedside localization technology.In the future,we need to continue to explore and improve the blind naso-jejunal intubation technology and localization technology to make the indwelling naso-jejunal intubation more rapid,safe and effective.
作者
谢艳梅
王建宁
XIE Yan-mei;WANG Jian-ning(The First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000;School of Nursing,Nanchang University,Nanchang,Jiangxi 330000)
出处
《赣南医学院学报》
2023年第11期1146-1150,共5页
JOURNAL OF GANNAN MEDICAL UNIVERSITY
关键词
鼻肠管
盲插
床边定位
Nasointestinal tube
Blind localization
Bedside localization
