Search

Establishment and Management of Enteral Nutrition Support in Critical Patients

Effect of 16F gastric tube as thoracic drainage tube on pain relief in patients after lung cancer resection: A controlled trial

Objective To explore the effect of 16F gastric tube on pain relief in postoperative lung cancer patients. Methods A total of 118 lung cancer patients were treated with radical resection of lung cancer in our hospital between January 2015 and May 2016. The patients were assigned into two groups: a 16F gastric tube group (16F group, 60 patients, 30 males and 30 females at age of 41-73 (52.13±7.83) years and a 28F drainage tube group (28F group, 58 patients, 25 males and 33 females at age of 45-75 (55.62±4.27) years. Clinical effects were compared between the two groups. Results There was no statistical difference in drainage time (4.47±1.03 dvs. 4.24±1.16 d, P=0.473), drainage amount (560.37±125.00 mlvs. 656.03±132.45 ml, P=0.478), incidences of pneumothorax (5/60 vs. 2/58, P=0.439), pleural effusion (6/60 vs. 3/58, P=0.522), and subcutaneous emphysema (3/60 vs. 1/58, P=0.635) between the two groups (P>0.05). The pain caused by the drainage tube in the16F group was less than that in the 28F drainage tube group with a statistical difference (F=4 242.996, P<0.001). The frequency of taking analgesics in the 16F group was significantly less than that in the 28F group (12/60vs. 26/58, P<0.001). Conclusion The effects of draining pleural effusions and promoting lung recruitment are similar between the 16F group and the 28F group. However, the wound pain caused by 16F gastric tube is significantly less than that by 28F drainage tube.

留置胃管患者非計劃性自行拔管的相關因素分析及對策

摘要:目的:調查留置胃管患者在留置期間發生非計劃性自行拔管的發生及相關因素,并探索護理對策。方法:調查218例留置胃管患者中非計劃性自行拔管的發生情況,并分析導致非計劃性自行拔管的相關因素。結果:在218例留置胃管患者中發生非計劃性自行拔管 62例,小于45歲患者非計劃性自行拔管發生率為39.5%,大于45歲患者非計劃性自行拔管發生率為21.2%,前者高于后者并有顯著性意義,癌癥患者非計劃性自行拔管發生率為36.4%,炎癥(急性胰腺炎)疾病患者非計劃性拔管為29%,其他疾病患者非計劃性拔管為18.6%,癌癥患者和急性重癥胰腺炎高于后一組患者有顯著意義,舒適的改變、約束不當、健康教育不到位、巡視不及時是造成非計劃性拔管的。結論:對留置胃管患者心理護理應貫穿其患病的全過程,在操作前做好健康教育,手術患者應有效的固定肢體,對留置胃管造成的不適,給予對癥護理,并增加護理人員加強巡視溝通,以減少非計劃性自行拔管的發生。

小卡子在防止重癥患者胃內容物外溢中的應用及效果

目的　總結和驗證小卡子在防止危重患者腸內營養液及管喂藥物后2 h內發生外溢的方法及效果。 方法　2011年5月－8月將ICU收治的80例需管喂的危重患者，隨機分為兩組，對照組采用傳統的胃管末端蓋子封閉胃管，試驗組采取胃管遠端加設小卡子夾閉胃管封閉法，比較兩種方法在預防胃內容物外溢中的作用及效果。 結果　試驗組患者無1例發生胃內容物外溢，兩組比較差異有統計學意義（P＜0.05）。小卡子夾閉胃管可有效防止胃內藥物或營養物質丟失。 結論　在胃管遠端使用小卡子夾閉胃管的方法能有效降低胃內容物外溢發生率。

Evaluation of Efficacy of Local Spraying Anaesthesis in Preoperative Implantation of Nasogastric Tube inPatients with Laryngeal Carcinoma

目的：比較常規鼻胃管置入法與鼻咽部局部噴霧麻醉后置胃管法對喉癌患者的影響。方法：將需要安置胃管的100例患者隨機分成兩組，每組50例。實驗組行鼻咽部噴霧麻醉，對照組按常規操作，比較兩組患者流淚、惡心、嘔吐、咳嗽反應，一次成功率及插管所需要時間、插入中暫停次數。結果：實驗組一次成功率高，患者反應輕，插管所需時間有顯著差異。結論：常規置胃管常因病員難受而中途暫停置管，實驗組置胃管前先作鼻咽部局部噴霧麻醉，可明顯減輕患者的痛苦，提高插胃管的一次成功率，插管過程中因病員難受暫停次數也明顯減少，使臨床護理工作時間縮短，對臨床護理工作有積極意義。

急性胰腺炎患者胃管留置中發生心搏驟停一例

Feasibility Analysis of Early Removing Nasogastric Tube Following Pancreaticoduodenectomy:A Retrospective Comparative Study of Homochronous Patients

ObjectiveTo assess the safety for removing nasogastric tube(NGT)within postoperative 24 h in Whipple pancreaticoduodenectomy (PD)patients. MethodsThe clinical data of 310 patients performed classic Whipple PD from January 2008 to March 2013 in this hospital were analyzed retrospectively. The patients were divided into early (≤24 h after operation)removing NGT group and late( > 24 h after operation)removing NGT group according to the time of NGT duration. The ratio of NGT reinsertion, time of solid diet tolerance, hospital stay, mortality, and major complications associated with PD were compared between two groups. Results①The demography and preoperative comorbidities characteristics were similar(P > 0.05).②There was no statistical difference of ratio of NGT reinsertion between two groups(P=0.450).③The differences of rates of major complications associated with PD and mortality were not statistically different(P > 0.05)by univariate analysis, but the rate of total complications in the early removing NGT group was significantly lower than that in the late removing NGT group (P=0.014)by multivariate analysis.④The average time of solid diet tolerance(P=0.013)and average hospital stay(P < 0.001)in the early removing NGT group were significantly shorter than those in the late removing NGT group. ConclusionFor patients comfort, NGT following PD should be removed as early as possible even immediately after extubation for selective patients.

留置鼻胃管位置判斷方法應用及研究現狀

針對目前國內外臨床確認留置鼻胃管位置的方法，該文分析和總結了各國相關的指南或專家推薦，對檢測依據、相關研究和國內外應用情況現狀進行了綜述，以期為臨床護理工作者提供參考和借鑒。通過引進國外適用方法，應用于臨床留置鼻胃管位置的正確判斷，有利于保障患者鼻飼安全，減輕患者痛苦，減少不良事件的發生，促進護理質量的持續改進。

Clinical Application of Nasogastric Tube in Perioperative Period of Colorectal Surgery

目的　探討在結直腸手術圍手術期中不常規應用鼻胃管的重要意義及其可行性。方法　選取2007年7月至2008年4月期間的結直腸手術患者40例，隨機平均分為不留置鼻胃管和留置鼻胃管2組，記錄２組各臨床指標及并發癥發生情況，并進行統計學分析。結果　不留置鼻胃管組患者舒適度增加，首次排氣、排便及住院時間縮短（Plt;0.05），住院費用也相應降低（Plt;0.05），肺炎、肺不張、切口感染等并發癥發生率低（Plt;0.05）。結論　結直腸手術不常規放置鼻胃管安全、可行，對減輕患者痛苦、減少術后并發癥的發生率、縮短患者住院時間有重要意義。

倒置胃管治療殘胃手術后食管癌一例