CAJ | 학술논문

目的：探讨注气法留置鼻胃肠双腔管在腹腔高压机械通气患者营养支持中的应用效果。方法采用前瞻性纳入腹腔高压机械通气患者20例，随机分为对照组和观察组，每组10例，对照组采用留置胃管进行胃肠减压，运用胃内注气法留置鼻肠管进行肠内营养支持；观察组运用胃内注气法留置鼻胃肠双腔管进行胃肠减压和肠内营养支持，比较2组置管时间、置管前后腹内压变化、置管注气量、一次置管成功率、置管操作对患者疼痛影响评分、停止胃肠减压时间、肠内营养开始时间和机械通气时间。结果观察组置管时间、置管注气量低于对照组，差异具有统计学意义（P＜0.01）；观察组置管操作对患者疼痛评分低于对照组，差异具有统计学意义（P＜0.01）；观察组一次置管成功率、置管前后腹内压变化与对照组相比，两组差异无统计学意义（P＞0.05）；腹腔高压缓解时间、肠内营养开始时间、机械通气时间，差异无统计学意义（P＞0.05）。结论胃内注气法留置鼻肠管成功率高，安全可靠，对腹腔高压机械通气患者留置鼻胃肠双腔管较同时留置鼻胃管和鼻肠管可改善患者舒适性，缩短置管时间，减少置管注气量。
목적：탐토주기법류치비위장쌍강관재복강고압궤계통기환자영양지지중적응용효과。방법채용전첨성납입복강고압궤계통기환자20례，수궤분위대조조화관찰조，매조10례，대조조채용류치위관진행위장감압，운용위내주기법류치비장관진행장내영양지지；관찰조운용위내주기법류치비위장쌍강관진행위장감압화장내영양지지，비교2조치관시간、치관전후복내압변화、치관주기량、일차치관성공솔、치관조작대환자동통영향평분、정지위장감압시간、장내영양개시시간화궤계통기시간。결과관찰조치관시간、치관주기량저우대조조，차이구유통계학의의（P＜0.01）；관찰조치관조작대환자동통평분저우대조조，차이구유통계학의의（P＜0.01）；관찰조일차치관성공솔、치관전후복내압변화여대조조상비，량조차이무통계학의의（P＞0.05）；복강고압완해시간、장내영양개시시간、궤계통기시간，차이무통계학의의（P＞0.05）。결론위내주기법류치비장관성공솔고，안전가고，대복강고압궤계통기환자류치비위장쌍강관교동시류치비위관화비장관가개선환자서괄성，축단치관시간，감소치관주기량。
Objective To investigate the application effect of nasal gastrointestinal double lumen catheter tube placement with air insufflation in mechanically ventilated patients with intra-abdominal hypertension.Methods A total of 20 patients with intra-abdominal hypertension were randomly divided into control group and observation group (n=10 in each group).Patients in control group received indwelling nasogastric tube for decompression and indwelling nasal intestine tube by air insufflation for enteral nutrition support .Patients in observation group received the dual lumen gastrointestinal tube for decompression and enteral nutrition support.The time required for catheterization,changes in intra-abdominal pressure before and after air insufflation,catheter success rate at one attempt,pain scores of patients to catheter operation, duration of decompression,enteral nutrition start time and the duration of mechanical ventilation were compared between two groups.Results The time required for catheterization,catheter air insufflation volume in observation group were significantly lower than those in control group (P <0.01);pain scores of patients to catheter operation were significantly lower in observation group than those in control group (P <0.01);There was no significantly difference in once catheter success rate,changes in intra-abdominal pressure before and after catheterization,abdominal high pressure relief time ,enteral feeding start time, and duration of mechanical ventilation between the two groups (P >0.05 ).Conclusions The technique of air insufflation has higher success rate for Indwelling nasal intestine tube in mechanically ventilated patients with intra-abdominal hypertension,and this method is safe and reliable,dual lumen gastrointestinal tube can improve patients'comfort,shorter catheterization time and reduce catheter air insufflation volume.