Application of improved two-step nasogastric double-lumen tube catheterization in critical patients in neurosurgery diseases
Objective To explore an improved two-step method of nasogastric double-lumen tube catheterization,which was performed by hand beside the bed for critical patients in neurosurgery diseases.Methods 120 critical patients in neurosurgery diseases who required enteral nutrition were collected and divided into traditional nasogastric tube group(the control group)and improved nasogastric double-lumen tube group(the improvement group)according to random mumber table method,with 60 patients in each group.Acute physiology and chronic health evaluation(APACHE Ⅱ)score and Glasgow Coma Scale(GCS)score,age,and body mass index(BMI)at the time of admission were recorded respectively.The operation time of nasogastric tube insertion,the heart rate before tube insertion and the maximum heart rate change during tube insertion,the nasal sinus CT,chest CT and nutuitional indicators of each patient berore tube insertion and 14 days after tube insertion were collected to determine whether there were complications such as nasosinusitis,aspiration pneumonia,gastrointestinal bleeding,nutrient solution retention and arrhythmia.Results There were no statistically significant differences in APACHE II score,GCS score,age and BMI between two groups at the time of admission(t=1.0598,1.2073,0.3104,0.9268;P=0.2914,0.2297,0.7568,0.3559,P>0.05).The catheterization time of the improvement group was(54.4±13)minutes,and the control group was(49.4±12.9)minutes;The catheterization time in the improvement group was slightly longer than that in the control group(t=2.1334,P=0.035(P<0.05).There was no statistically significant difference in terms of heart rate changes between the improvement group and the control group during catheterization(P>0.05).The improvement group was superior to the control group in the control of sinusitis(20.0%,36.7%),pneumonia(26.7%,46.7%%)and gastric retention(5.0%,16.7%)(P<0.05).There were no statistically significant differences in gastrointestinal bleeding and arrhythmia between two groups(P>0.05).After 14 days of enteral nutrition treatment,the levels of the albumin,prealbumin,hemoglobin,and lymphocyte counts in the improvement group were better than those in the control group.Conclusion The improved two-step nasogastric double-lumen tube catheterization can be completed by hand at bedside.Compared with traditional methods,although the catheterization time is slightly longer,the incidence of sinusitis and aspiration pneumonia is significantly reduced,and there is no increase of complications ralated to tube insertion;Meanwhile,the levels of nutritional indicators in the improvement group are significantly better than those in the control group.This method is safe,effective and convenient,and is worthy of clinical promotion.
critical patients in neurosurgery diseasesnasogastric double-lumen tubecatheterizationbare hands
万方数据
维普
