摘要目的：观察脑卒中患者胃管留置不同长度的应用效果,以寻求脑卒中患者胃管留置最佳长度。方法将我院182例经鼻胃管肠内营养的脑卒中患者分为对照组( n=58)、观察A组( n=60)和观察B组(n=64),对照组胃管留置长度为鼻尖经耳垂至胸骨剑突的体表距离(45~55 cm),观察A组为鼻尖经耳垂至胸骨剑突的体表距离再延长15 cm (60~70 cm ),观察B组为患者眉心至脐的体表距离(55~65 cm),比较3组患者胃管置入胃内的情况、反流、呛咳及误吸的发生率和胃内残留量监测情况。结果对照组53例(91.38%)胃管末端在贲门部,观察A组44例(73.33%)胃管末端在幽门部,观察B组55例(85.94%)胃管末端在胃体部；观察A组、观察 B组反流、呛咳及误吸发生率均低于对照组(P<0.01),监测胃内残留量大于对照组(P<0.01)；观察A组、观察B组胃内残留量监测和反流、呛咳及误吸发生率差异无统计学意义(P>0.05),但观察A组有8例(13.33%)胃管在胃内扭曲或打结,2例(3.33%)进入十二指肠。结论以患者眉心至脐的体表距离(55~65 cm)留置胃管,方法简捷,对于不同身高群体的脑卒中患者更为科学合理,值得在临床实践工作中推荐。

abstractsObjective To explore the gastric tube indwelling with different length, in order to find out the best length for stroke patients. Methods A total of 182 stroke patients with enteral nutrition by nasogastric tube were randomly assigned into control group (n=58), observation group A (n=60) and observation group B(n=64). The indwelling length of nasogastric tube was from eyebrows to earlap then mucronate cartilage in the control group (45-55 cm); based on this length, additional 15 cm was extended in observation group A (60-70 cm);the length for observation group B was 55-65 cm from eyebrows to navel. The situation of gastric tube inserting, the incidence of regurgitation, bucking and aspiration and the residual gastric volume in three groups were compared. Results A total of 53 cases (91. 38%) of the control group had gastric tube ends at the cardia;in the observation group, 44 cases (73. 33%) of group A had gastric tube ended at the pylorus, and 55 cases (85. 94%) of observation group B in the body of the stomach. The incidence of regurgitation, bucking and aspiration in observation group A and group B were both significant lower than those of the control group (P<0.01), but the residual gastric volumes in two groups were more than that of the control group (P <0. 01);there were no significant differences between group A and group B in residual gastric volume and the incidence of regurgitation, bucking and aspiration (P >0. 05). However, there were 8 cases (13. 33%) of gastric tube twisting or knotting in stomach in group A, and 2 cases ( 3. 33%) of gastric tube entering the duodenum. Conclusions Indwelling gastric tube with the length of 55 -65 cm ( from eyebrow to navel) is simple and reasonable for stroke patients in patients with different height, so it is worthy of promotion in clinical practice.