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胃管插入长度对新生儿洗胃效果的观察*

作者:章兰萍 尚 剑 黄春华

所属单位:北京大学深圳医院产科 (广东 深圳 518036)

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摘要

目的 探讨胃管插入长度对新生儿洗胃效果的影响。方法 选取我院2017年3月-2018年3月产科出生的新生儿因吞入 羊水,出现呕吐病例96例作为研究对象,将其随机分为两组,每组48例,即为对照组及观察组。对两组新生儿采用 不同的胃管插入长度,即对照组新生儿胃管插入长度为前额正中发际-剑突。观察组新生儿胃管插入长度为前额正 中发际-肚脐。结果 观察组新生儿的洗胃效果要优于对照组新生儿,且观察组新生儿在洗胃过程中洗胃时间明显短 于对照组,胃粘膜损伤出血率发生低于对照组。结论 采用前额正中发际-肚脐测量胃管插入长度洗胃效果显著,并 且缩短洗胃的时间,减少因反复冲洗对胃粘膜的损伤,有效性和安全性显著,具有临床推广的价值。

Objective To investigate the effect of different insertion length of gastric tube in newborn gastric lavage. Methods 96 newborns born in obstetrics of our hospital from March -2017 to March 2018, who swallowed amniotic fluid and vomited were randomly divided into two groups, each group of 48 cases, as control group and observation group. Different insertion lengths of gastric tube were used in the two groups of newborns, namely, the length of the insertion gastric tube in the control group was in the middle of the foreheads hairline-processus xiphoideus. the length of the insertion gastric tube in the observation group was in the middle of the foreheads hairline-umbilicus. Results The effect of newborn gastric lavage in the observation group was superior to the effect in the control group, and gastric lavage time in the observation group was obviously shorter than that in the control group, and the gastric mucosal injury bleeding rate in the observation group was lower than that in the control group. Conclusion Newborns using gastric lavage length of the middle of the foreheads hairline-umbilicusis has remarkable lavage effects, which can shorten the time of gastric lavage and can reduce gastric mucosal damage by repeated flushing, and can be effective and safety, and have the value of clinical promotion.

【关键词】新生儿洗胃;胃管插入长度;临床效果

【中图分类号】R272.1;R322.4+4

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2018.04.012

前言

新生儿呕吐是因新生儿在母体子宫内或分娩时, 有大量羊水、母血或母体阴道分泌物被吞入或吸入, 对新生儿的胃黏膜造成刺激,其在出生24h内出现黄 色或咖啡色的黏液呕吐物[1]。由于新生儿反射能力 差,呕吐物容易呛入呼吸道引起窒息、肺炎,临床上 常采用洗胃方法洗净胃内的粘液,从而避免因呕吐 而引起对新生儿的危害[2]。但是,由于新生儿本身的 生理及解剖特点,例如:免疫力低,体重轻,胃容量 小,胃肠壁薄等,所以在进行插入胃管的操作时,需 要将胃管置入到一个恰当的长度,不能过深,也不能 过浅,否则都将影响到最后的洗胃效果,并且容易发生胃粘膜损伤出血等并发症。因此,在本次研究中, 主要探讨治疗新生儿因吞入羊水导致的呕吐时,洗胃 过程中两种插管长度对洗胃效果的影响。现报告如 下。