亚甲蓝在机械通气患者胃肠反流误吸监测中的临床应用

摘要

目的 探讨亚甲蓝标记法在诊断机械通气患者胃肠反流误吸中应用的可行性及实用性.方法 将亚甲蓝对营养液进行标记并应用于45例机械通气鼻饲的患者,按照机械通气、鼻饲及相关疾病的护理常规进行责任制护理.40例患者行床头抬高30°～45°体位,平卧位5例,遵循按需吸痰原则,吸出气道分泌物后观察痰液颜色,以判断患者是否发生胃肠反流.结果 在45例机械通气患者气道分泌物中,分泌物无淡绿色41例,淡绿色4例,其中平卧位3例,床头抬高30° ～45°体位1例.结论 亚甲蓝标记法可以快速诊断机械通气患者胃肠反流发生.床头抬高30°～ 45°卧位可有效减少胃肠反流的发生.%Objective To investigate the feasibility of methylene blue marking method in the diagnosis of gastrointestinal reflux aspiration during mechanical ventilation.Methods Methylene blue marking nutrient solution was applied to 45 patients with mechanical ventilation through nasal feeding.The airway secretions color was observed to determine whether the patients had gastrointestinal reflux aspiration.Results Totally 41 cases had no pea-green secretion and 4 cases had pea-green secretion,among them 3 cases were at horizontal position and 1 case was at the position of elevating head of bed to 30°to 45°.Conclusions Methylene blue marking method can diagnose gastrointestinal reflux in patients with mechanical ventilation.Elevating the head of bed up to 30° to 45° is an effective measure to reduce the gastrointestinal reflux incidence.