Department of Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
Medicine (Baltimore). 2023 Dec 15;102(50):e36452. doi: 10.1097/MD.0000000000036452.
The objective of this study is to explore the application effect of B-ultrasound positioning in assisting nasointestinal tube implantation in critically ill patients. This study is a retrospective study. In this study, 90 cases of severe patients with nasointestinal tube implantation were included. According to the different ways of nasointestinal tube insertion received by patients, 61 patients with conventional blind insertion methods were included in the blind insertion group, and 29 patients with conventional methods and B-ultrasound assisted positioning were included in the B-ultrasound positioning group. The general clinical data, success rate of catheterization, catheterization time, pyloric passage rate, and target nutritional value time of the 2 groups were compared. The changes of the 2 groups after catheterization were compared by SOFA and APACHE II. The contents of albumin and lymphocyte count were compared between the 2 groups before and after catheterization. The time of target nutritional value of the patients of the B-ultrasound positioning group was markedly decreased comparing with the patients of the blind insertion group. The index of catheterization time of the patients between the blind insertion group and B-ultrasound positioning group had no obvious contrast. The APACHE II score and SOFA score of the patients of the B-ultrasound positioning group were obviously lower than the blind insertion group. The contents of lymphocyte count of the patients of the B-ultrasound positioning group were markedly increased comparing with the patients of the blind insertion group after catheterization, but the contents of albumin content had no obvious change. The scores of respiratory system, circulatory system, nervous system, and urinary system in the B-ultrasound positioning group were significantly higher than those in the blind insertion group, while the COPT scores were significantly lower than those in the blind insertion group. B-ultrasound assisted nasointestinal tube implantation is well tolerated in critically ill patients, and can effectively ameliorate the nutritional status and of the ill patients.
本研究旨在探讨超声定位在协助危重症患者鼻肠管置管中的应用效果。本研究为回顾性研究,纳入 90 例需行鼻肠管置管的危重症患者,根据患者接受的鼻肠管置管方式的不同分为盲插组(61 例,常规盲插)和超声定位组(29 例,常规联合超声定位),比较两组一般临床资料、置管成功率、置管时间、幽门通过率、目标营养达标时间,比较两组置管后 SOFA 和 APACHEⅡ评分的变化,比较两组置管前后白蛋白、淋巴细胞计数的变化。与盲插组比较,超声定位组患者的目标营养达标时间明显缩短,盲插组和超声定位组患者的置管时间无明显差异;与盲插组比较,超声定位组患者的 APACHEⅡ评分和 SOFA 评分明显降低,置管后患者的淋巴细胞计数明显升高,白蛋白含量无明显变化;超声定位组患者呼吸系统、循环系统、神经系统和泌尿系统的 COPT 评分明显高于盲插组,COPT 评分明显低于盲插组。超声辅助鼻肠管置管在危重症患者中耐受性良好,能有效改善患者的营养状况。