老年螺旋型鼻肠管置管护理中行腹部按摩刺激对成功率及胃肠蠕动、耐受影响(1)
摘要：目的 探究老年螺旋型鼻肠管置管护理中行腹部按摩刺激对其成功率、胃肠蠕动及耐受情况的影响。方法 随机选取我院消化科就诊的76例行螺旋型鼻肠管置管老年男性患者为研究对象，按照随机数字法分为实验组38例、对照组38例。对照组采用常规鼻肠管置管方法；实验组置在对照组的基础知识予以腹部按摩处理。对比两组置管成功率、不良反应及耐受情况。结果 ①实验组患者各时间点置管成功率均显著高于对照组，P<0.05；置管72 h后实验组置管成功率(84.21%)显著高于对照组(57.89%)，P=0.009；②实验组患者不良反应总发生率(52.63%)显著低于对照组(86.84%)，P<0.05；③实验组患者按摩前、后呼吸、心率及血压基本体征均无显著性变化，P>0.05。结论 腹部按摩可促进老年螺旋型鼻肠管置管后的胃肠蠕动，提高置管成功率，且患者的耐受情况尚可。
关键词：螺旋型鼻肠管；腹部按摩；成功率
Abstract：Objective To investigate the effects of success rate， gastrointestinal motility and tolerance of abdominal massage in the nursing for spiral nasalgastric catheter placement in elderly patients.Methods That 76 elderly and male cases with detaining spiral nasointestinal tube from the department of gastroenterology in our hospital were randomly selected and divided into the experience group and the control group both with 38 cases.The cases in control group were treated with conventional nasal tube catheter method，an the cases in experimental group were treated with abdominal massage on the basis of the control group.The success rate， adverse reactions and tolerance between the two groups were compared.Results ①The success rate of the cases in the experimental group was significantly higher than that in the control group， P<0.05；The success rate after 72h in the experimental group (84.21%) was significantly higher than that in the control group (57.89%)，P=0.009.②The total incidence of adverse reactions in the experimental group (52.63%) was significantly lower than that in the control group (86.84%)，P<0.05.③There was no significant change on basic vital signs in the experimental group， P>0.05.Conclusion Abdominal massage can promote the spiral nasointestinal tube after catheter gastrointestinal peristalsis， increase the success rate of catheterization on elderly patients，and the tolerance of the method is good.
, 百拇医药
Key words：Spiral distal end jejunal tube；Abdominal massage；Success rate
作为肠内营养的主要方式之一，鼻肠管主要用于鼻饲不耐受、高风险肺炎、胃潴留、胃排空延迟等无法进行正常营养摄入患者[1]。国内相关研究表明[2]，鼻肠管的肠内营养方式可以有效降低呕吐、误吸、肺部感染等并发症。螺旋型鼻肠管是一种自推式导管，置入胃内后需依赖患者胃的蠕动通过幽门到达小肠肠腔内，然而老年人属于胃肠动力较差的患者，因此老年螺旋型鼻肠管置管成功率并不理想[3，4]。本研究观察老年螺旋型鼻肠管置管护理中予以腹部按摩刺激的辅助方式，效果满意，现报道如下：
1资料与方法
1.1一般资料 随机选取2012年5月～2015年5月我院消化科就诊的76例行螺旋型鼻肠管置管老年男性患者为研究对象，按照随机数字法分为实验组38例、对照组38例。纳入标准[5，6]：所有研究对象均为首次置管且无语言、意识障碍；无肠梗阻、胃肠出血、急腹症等消化系统疾患；自愿签署相关知情同意书；排除标准：排除急性心梗、严重全身性疾病患者。两组患者年龄、基础疾病分布等一般资料比较无显著性差异(P>0.05)，具有可比性。
1.2方法 对照组置入鼻肠管后通过患者自身胃肠蠕动到达十二指肠或空肠上段；实验组置入鼻肠管后予以顺时针按摩上腹部直至螺旋管到达十二指肠或空肠上段，按摩手法为手掌四指并拢紧贴腹壁皮肤，予以适当大小垂直于腹壁平面的压力，沿胃对应的体表区域做顺时针、匀速按摩，5 min/次、1次/4 h。采用纽迪希尔公司提供CH-10富尔凯螺旋型鼻肠管，外径3.33 mm、长145 cm；置管及按摩均由统一的专业护士操作。, 百拇医药(李雯雯)
关键词：螺旋型鼻肠管；腹部按摩；成功率
Abstract：Objective To investigate the effects of success rate， gastrointestinal motility and tolerance of abdominal massage in the nursing for spiral nasalgastric catheter placement in elderly patients.Methods That 76 elderly and male cases with detaining spiral nasointestinal tube from the department of gastroenterology in our hospital were randomly selected and divided into the experience group and the control group both with 38 cases.The cases in control group were treated with conventional nasal tube catheter method，an the cases in experimental group were treated with abdominal massage on the basis of the control group.The success rate， adverse reactions and tolerance between the two groups were compared.Results ①The success rate of the cases in the experimental group was significantly higher than that in the control group， P<0.05；The success rate after 72h in the experimental group (84.21%) was significantly higher than that in the control group (57.89%)，P=0.009.②The total incidence of adverse reactions in the experimental group (52.63%) was significantly lower than that in the control group (86.84%)，P<0.05.③There was no significant change on basic vital signs in the experimental group， P>0.05.Conclusion Abdominal massage can promote the spiral nasointestinal tube after catheter gastrointestinal peristalsis， increase the success rate of catheterization on elderly patients，and the tolerance of the method is good.
, 百拇医药
Key words：Spiral distal end jejunal tube；Abdominal massage；Success rate
作为肠内营养的主要方式之一，鼻肠管主要用于鼻饲不耐受、高风险肺炎、胃潴留、胃排空延迟等无法进行正常营养摄入患者[1]。国内相关研究表明[2]，鼻肠管的肠内营养方式可以有效降低呕吐、误吸、肺部感染等并发症。螺旋型鼻肠管是一种自推式导管，置入胃内后需依赖患者胃的蠕动通过幽门到达小肠肠腔内，然而老年人属于胃肠动力较差的患者，因此老年螺旋型鼻肠管置管成功率并不理想[3，4]。本研究观察老年螺旋型鼻肠管置管护理中予以腹部按摩刺激的辅助方式，效果满意，现报道如下：
1资料与方法
1.1一般资料 随机选取2012年5月～2015年5月我院消化科就诊的76例行螺旋型鼻肠管置管老年男性患者为研究对象，按照随机数字法分为实验组38例、对照组38例。纳入标准[5，6]：所有研究对象均为首次置管且无语言、意识障碍；无肠梗阻、胃肠出血、急腹症等消化系统疾患；自愿签署相关知情同意书；排除标准：排除急性心梗、严重全身性疾病患者。两组患者年龄、基础疾病分布等一般资料比较无显著性差异(P>0.05)，具有可比性。
1.2方法 对照组置入鼻肠管后通过患者自身胃肠蠕动到达十二指肠或空肠上段；实验组置入鼻肠管后予以顺时针按摩上腹部直至螺旋管到达十二指肠或空肠上段，按摩手法为手掌四指并拢紧贴腹壁皮肤，予以适当大小垂直于腹壁平面的压力，沿胃对应的体表区域做顺时针、匀速按摩，5 min/次、1次/4 h。采用纽迪希尔公司提供CH-10富尔凯螺旋型鼻肠管，外径3.33 mm、长145 cm；置管及按摩均由统一的专业护士操作。, 百拇医药(李雯雯)