不同胃管固定法对食管癌术后胃管非计划性拔管的影响

摘要

目的：探讨3种不同胃管固定方法对食管癌术后胃管非计划性拔管的影响。方法将234例行食管癌切除术留置胃管的患者，采用随机数字表法分为传统1组74例，传统2组79例，实验组81例。传统1组采用3 M丝绸胶布固定胃管；传统2组采用白扁带系双套结固定胃管；实验组采用“工”字形鼻贴联合活瓣式脸贴固定胃管。观察3组胃管留置过程中胃管发生移位和脱出情况。结果实验组胃管移位和脱管发生率均低于对照1组和2组（均P＜0.05）；胃管脱出后，传统1组和2组分别有2例和1例发生吻合口瘘，实验组无1例发生吻合口瘘。结论“工”型鼻贴联合活瓣式脸贴固定胃管方法能有效减少非计划性拔管的发生，是一种较好的胃管固定方法，值得临床推广应用。%Objective To investigate the effects of three external nasogastric tube fixations on unplanned nasogastric tube removal after radical esophagectomy for esophageal cancer.Methods Two hundred and thirty four esophageal cancer patients who underwent radical esophagectomy with nasogastric intubation were assigned into conventional group I(n=74),conventional group II (n=79)and experiment group(n=81)using random number table.For external fixation of the nasogastric tube,the traditional group I used“3M”silk tape,the traditional group II used a white flat strap with two knots and the experiment group used an"I"-shaped nasal fixation tape combined with a flapping cheek fixation tape.The three groups were compared in terms of displacement of the indwelling nasogastric tube and slippage of the tube.Results The displacement rate of nasogastric tube and the rate of slippage in the experiment group were both significantly lower than those in both conventional groups I and II(all P<0.05).Conclusion The"I"-shaped nasal fixation tape combined with a flapping cheek fixation tape in fixing the nasogastric tube can effectively reduce the incidence of unplanned removal of nasogastric tube and meanwhile the patients may feel comfort and satisfactory.