耳穴贴压提高肿瘤危重症患者鼻肠管置管成功率临床观察

目的观察耳穴贴压法对肿瘤重症患者留置鼻肠管成功率的影响。方法将120例肿瘤危重症患者根据随机数字表法分为耳穴贴压组、甲氧氯普胺组和对照组,每组40例。统计分析3组患者置管成功率、置管时间、2次置管率、置管并发症等,监测患者置管前、置管中、置管后1 h的心率(heart rate,HR)、呼吸频率(respiratory rate,RR)、平均动脉压(mean arterial pressure,MAP)、指端血氧饱和度(percutaneous oxygen saturation,SpO 2)变化。结果耳穴贴压组、甲氧氯普胺组置管成功率均高于对照组(P<0.05),两者的二次置管率均明显低于对照组(P<0.05)。3组患者置管时间比较,差异均有统计学意义(P<0.05),甲氧氯普胺组与耳穴贴压组置管时间较对照组明显缩短(P<0.05);3组患者置管深度比较,差异无统计学意义(P>0.05)。与置管前比较,置管中3组患者HR、RR均明显加快(P<0.05),MAP明显增高(P<0.05),SpO 2均无明显变化(P>0.05);与置管中比较,置管后1 h,3组患者HR、MAP、RR均明显降低(P<0.05);与置管前比较,置管后1 h,3组患者HR、MAP、RR、SpO 2均无明显变化(P>0.05)。置管中,甲氧氯普胺组和耳穴贴压组患者HR明显低于对照组(P<0.05)。结论耳穴贴压法可提高肿瘤危重症患者鼻肠管的置管成功率,无明显并发症发生。

Effect of Auricular Point Sticking in Improving the Success Rate of Nasointestinal Tube Placement in Critically Ill Patients with Tumor

Objective To investigate the effect of auricular point sticking on the success rate of nasointestinal tube placement in critically ill patients with tumor. Methods A total of 120 critically ill patients with tumor were divided into auricular point sticking group, metoclopramide group, and control group using a random number table, with 40 patients in each group. The three groups were observed in terms of success rate of tube placement, time of tube placement, rate of second tube placement, and complications of tube placement, and the changes in heart rate (HR), respiratory rate (RR), mean arterial pressure (MAP), and blood oxygen saturation (SpO2) at fingertip were monitored before, during, and at 1 hour after tube placement. Results The auricular point sticking group and the metoclopramide group had a significantly higher success rate of tube placement and a significantly lower rate of second tube placement than the control group (P<0.05). There was a significant difference in the time of tube place between the three groups (P<0.05), and the metoclopramide group and the auricular point sticking group had a significantly shorter time of tube placement than the control group (P<0.05). There was no significant difference in the depth of tube placement between the three groups (P>0.05). During tube placement, all three groups had significant increases in HR, RR, and MAP (P<0.05), with no significant change in SpO2 (P>0.05); all three groups had significant reductions in HR, MAP, and RR from during tube placement to 1 hour after tube placement (P<0.05); there were no significant changes in HR, MAP, RR, and SpO2 from before tube placement to 1 hour after tube placement (P>0.05). During tube placement, the metoclopramide group and the auricular point sticking group had a significantly lower HR than the control group (P<0.05). Conclusion Auricular point sticking can improve the success rate of nasointestinal tube placement in critically ill patients with tumor, with no obvious complications.