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目的探讨机械通气患者在床边胃镜下放置鼻空肠管行早期肠内营养的护理配合及体会。方法 52例需行空肠管置入的机械通气患者,先将鼻空肠管营养管插入胃腔,置入胃镜,置入异物钳钳夹鼻空肠管前端,在胃镜引导下向前推至屈氏韧带以下15 cm,退镜并固定。结果 52例气管插管患者一次置管成功50例(失败2例均为鼻肠管前端在胃腔内打折盘曲未进入屈氏韧带以下,再次置管后均成功),一次置管成功率96.15%(50/52);4例在置管过程中出现血压下降,经减小或停用镇静药物后好转;2例出现心率增快并呼吸急促,经处理1 h内好转;置管成功后无肠内营养液反流及误吸发生。结论对于机械通气患者在床边胃镜引导下行鼻空肠管置入,可以建立有效的肠内营养途径,简便易操作,成功率高,可有效减少机械通气并发症,需加强护理。
Objective To investigate the nursing cooperation and experience of early enteral nutrition in nasal jejunum placed under bed gastroscopy in patients with mechanical ventilation. Methods Fifty-two patients undergoing mechanical ventilation with jejunal tube insertion were placed into the gastric cavity with gastroscope and inserted into the anterior end of the nasal jejunum with foreign body forceps. 15 cm below the ligament, remove the mirror and fixed. Results 52 cases of tracheal intubation in a success of 50 cases (failed in 2 cases are the front of the nasal tube in the stomach disc disc discount did not enter the Qiu’s ligament below, after re-catheterization were successful), a success rate of 96.15% (50/52); 4 cases of blood pressure in the catheter during the decline, reduced or discontinued sedative drugs improved; 2 cases of heart rate increased and shortness of breath, improved within 1 h after treatment; after the success of catheter Enteral nutrition reflux and aspiration occur. Conclusions For patients with mechanical ventilation under nasal jejunum guided by bed gastroscopy, effective enteral nutrition can be established, which is simple and easy to operate with high success rate, which can effectively reduce the complications of mechanical ventilation and need intensive care.