超声联合胃窦渐进式注水法留置鼻肠管在危重症患者中的应用

Application of Ultrasound Combined with Progressive Gastric Antral Water Injection Method for Indwelling Nasointestinal Tube in Critically Ill Patients

摘要: 目的：探讨超声联合胃窦渐进式注水法留置鼻肠管在危重症患者中的应用效果，并分析其在提高置管成功率、缩短置管时间及降低并发症发生率方面的临床价值。方法：选取50例需留置鼻肠管的危重症患者作为研究对象，根据置管方法不同分为超声引导组28例和徒手盲放组22例。超声引导组采用超声联合胃窦渐进式注水法置管，徒手盲放组采用常规徒手盲放法置管。比较两组患者首次置管成功率、二次置管成功率、总置管成功率、并发症发生率及置管时间。结果：超声引导组首次置管成功率为85.7%，显著高于徒手盲放组的45.5%；总置管成功率为96.4%，高于徒手盲放组的77.3%，差异均有统计学意义(P < 0.05)。两组首次失败后二次置管成功率比较差异无统计学意义(P > 0.05)。超声引导组并发症发生率为10.7%，低于徒手盲放组的31.8%；平均置管时间为(38.2 ± 9.5) min，短于徒手盲放组的(52.6 ± 12.8) min，差异均有统计学意义(P < 0.05)。结论：超声联合胃窦渐进式注水法应用于危重症患者鼻肠管留置中，能够明显提高首次置管成功率和总置管成功率，缩短置管时间，减少并发症发生，具有较好的安全性和有效性，可为危重症患者肠内营养通路的建立提供更可靠的技术支持。

Abstract: Object: This paper aims to explore the application effect of ultrasound combined with progressive gastric antral water injection method for indwelling nasointestinal tube in critically ill patients, and analyze its clinical value in improving the success rate of tube placement, shortening the tube placement time, and reducing the incidence of complications. Method: 50 critically ill patients requiring nasointestinal catheterization were selected as the study subjects, and were divided into an ultrasound-guided group of 28 cases and a manual blind placement group of 22 cases according to different catheterization methods. The ultrasound-guided group used ultrasound combined with progressive gastric antral water injection method for catheter placement, while the manual blind placement group used conventional manual blind placement method for catheter placement. Compare the success rates of first catheterization, second catheterization, total catheterization, incidence of complications, and catheterization time between two groups of patients. Result: The success rate of the first catheterization in the ultrasound-guided group was 85.7%, significantly higher than the 45.5% in the manual blind placement group; The total success rate of catheterization was 96.4%, which was higher than the 77.3% in the group receiving blind placement by hand, and the differences were statistically significant (P < 0.05). There was no statistically significant difference in the success rate of second catheterization between the two groups after the first failure (P > 0.05). The incidence of complications in the ultrasound-guided group was 10.7%, which was lower than the 31.8% in the manual blind placement group; The average catheterization time was (38.2 ± 9.5) minutes, which was shorter than the (52.6 ± 12.8) minutes in the manual blind placement group, and the differences were statistically significant (P < 0.05). Conclusion: The application of ultrasound combined with progressive gastric antral water injection method in nasointestinal tube placement in critically ill patients can significantly improve the success rate of initial and total tube placement, shorten the tube placement time, reduce the occurrence of complications, and have good safety and effectiveness. It can provide more reliable technical support for the establishment of enteral nutrition pathway in critically ill patients.