摘要目的 探讨在一定辅助方法下床边放置鼻肠营养管在危重症患者应用中的安全性和有效性.方法 2013年9月1日至2015年9月10日安徽医科大学第二附属医院重症医学科不能经口及经胃进食的危重症患者,按本科执行的床边放置鼻肠营养管操作规范,根据病情特点选择辅助方法,行床边放置鼻肠管,记录操作时间、营养管位置和相关并发症等,并对资料进行回顾性分析.结果 共有21例不能经口及经胃进食患者,床边放置鼻肠管23例次,营养管头端跨幽门成功率为91.3％ (21/23),将营养管头端送达Treitz韧带以下10 cm的成功率为87.0％ (20/23);平均操作时间为(14.10±1.80) min,平均放置鼻肠管费用为(297.01±35.26)元,无严重并发症发生.结论 辅助床边盲视放置鼻肠营养管操作简便、安全,费用低,成功率高,对于不能经口及胃进食患者,是建立肠内营养通道实现早期恢复肠内营养的良好选择.

abstractsObjective To evaluate the safety and effectiveness of bedside nasointestinal nutritional tube insertion with specific guiding techniques in critically ill patients.Methods Critically ill patients who could not take oral or gastric feeding were collected from September 1st, 2013 to September 10th, 2015 in Intensive Care Unit of The Second Hospital of Anhui Medical University.In these patients, bedside nasointestinal tube insertion was performed according to the relevant standard operating procedure in our department, and guiding technique was chosen based on patients' clinical characteristics.Operation time, position of tube tip and complications associated with the bedside operations were recorded for retrospective analysis.Results A total of 21 patients were collected in this study, in whom 23 bedside insertions were preformed.In 21 insertions (91.3％), the tip of the tube was successfully inserted across the transpyloric plane;and in 20 insertions (87.0％), 10 cm distal to the ligament of Treitz.The average operation time was (14.10 ± 1.80) min.The average cost was (297.01 ± 35.26) yuan.No severe complications were occurred.Conclusions The bedside nasointestinal feeding tube insertion without visual guiding is simple, safe, low-cost, and of high success rate.It may be a good choice for establishing enteral nutrition channel in order to implement early enteral nutrition in patients unable to take oral or gastric feeding.