大脑半球大面积脑梗死患者血管内低温治疗时实现早期幽门后喂养的流程优化研究
Optimization of early post-pyloric feeding process during intravascular hypothermia in patients with large hemi-spheric infarction
曹闻亚 1常红 1李苗 1范琳琳 1田飞 1刘刚1
作者信息
- 1. 首都医科大学宣武医院神经内科,北京 100053
- 折叠
摘要
目的 优化大脑半球大面积脑梗死患者血管内低温治疗时实现早期幽门后喂养的护理流程并分析其应用效果.方法 采用便利抽样法,选取2019年1月—2021年12月连续入住北京某三甲医院神经科ICU行血管内低温治疗的53例首发大脑半球大面积脑梗死患者为研究对象,其中对照组为2019年1月—2020年5月的25例患者,实验组为2020年6月—2021年12月的28例患者.实验组采用优化护理流程,对照组采用常规护理流程.比较两组患者鼻肠管置入成功率、置管相关并发症发生率、置管总耗时及血管内低温治疗启动耗时.结果 实验组的鼻肠管置入成功率为85.7%,高于对照组(P<0.05);置管总耗时(48.84±19.12)min,较对照组明显缩短(P<0.05);实验组鼻肠管置入时鼻咽黏膜出血、消化道出血及心律失常的发生率低于对照组(P<0.05);两组间血管内低温启动耗时差异无统计学意义(P>0.05).结论 大脑半球大面积脑梗死患者血管内低温治疗期间实现早期幽门后喂养的优化流程可确保血管内低温治疗按时启动,有效缩短鼻肠管置管耗时,提高置管成功率,减少置管相关并发症的发生.
Abstract
Objective To optimize the nursing process for achieving early post-pyloric feeding during intravascular hypothermia for patients with large hemispheric infarction,and to investigate its application effect.Methods The conve-nience sampling method was used to select 53 patients with first-episode large hemispheric infarction who were admitted to the intensive care unit of Department of Neurology and underwent intravascular hypothermia in a grade A tertiary hospital in Beijing,China,from January 2019 to December 2021.The 25 patients from January 2019 to May 2020 were enrolled as control group,and the 28 patients from June 2020 to December 2021 were enrolled as experimental group.The patients in the experimental group received optimized nursing process,and those in the control group received conventional nursing process.The two groups were compared in terms of the success rate of nasointestinal tube placement,the incidence rate of catheter-related complications,the total time of catheterization,and the start-up time of intravascular hypothermia.Results Compared with the control group,the experimental group had a significantly higher success rate of nasointesti-nal tube placement(85.7%vs 52.0%,P<0.05),a significantly shorter total time of catheterization[(48.84±19.12)minutes vs(75.90±18.63)minutes,P<0.05],and significantly lower incidence rates of nasopharyngeal mucosa bleeding,gastrointestinal bleeding,and arrhythmia(P<0.05),while there was no significant difference in the start-up time of intra-vascular hypothermia between the two groups(P>0.05).Conclusion The optimized process of early post-pyloric feeding during intravascular hypothermia for patients with large hemispheric infarction can ensure the timely start-up of intravascu-lar hypothermia,effectively shorten the time of nasointestinal tube placement,improve the success rate of catheterization,and reduce the onset of catheter-related complications.
关键词
大脑半球大面积脑梗死/血管内低温治疗/早期幽门后喂养/流程优化Key words
Large hemispheric infarction/Intravascular hypothermia/Early post-pyloric feeding/Process optimization引用本文复制引用
基金项目
北京市卫生健康委项目(BHTPP2022084)
出版年
2024
国家科技期刊平台
NSTL
万方数据