目的 总结胰十二指肠切除术后早期行肠内营养的护理效果。 方法 对2010年5月－12月30例胰十二指肠切除术后经鼻肠管行肠内营养患者的护理方法及措施进行回顾总结。 结果 全部患者术前均顺利完成留置鼻肠管，术后除7例患者分别发生堵管、咽炎、腹胀、营养液返流等并发症予以及时处置外，其余患者均顺利安全完成肠内营养治疗，患者营养状况在短时间内得到有效改善和恢复。 结论 胰十二指肠切除术后经鼻肠管行早期肠内营养，能促进肠功能早期恢复，良好的护理可保证肠内营养的顺利实施，显著改善患者围术期的营养状况。
ObjectiveTo assess the clinical efficacy of sonography guided Freka Trelumina placement by stylet displacement in patients with severely impaired gastric emptying. MethodsTwenty-two patients with severely impaired gastric emptying monitored in the Intensive Care Unit from January 8 to May 18, 2016 were chosen to be our study subjects. Freka Trelumina was placed under ultrasonic guidance, and the guide wire displacement was used to determine the location of the catheter. We recorded whether the patient had an intra-gastric injection of warm water, the manual pushing times before the catheter passed through the pylorus, whether the operation succeeded, the time spent on guiding the placement, and the catheter depth. The pros and cons of the method in clinical use, and whether fasting state helped reduce the operating time were analyzed. ResultsAmong the 22 patients, 20 had a successful Freka Trelumina placement, and the success rate was 91%. The number of manual pushing before the catheter passed through the pylorus was 1 in 4 cases (20%), 2 in 5 (25%), and equal to or more than 3 in 11 cases (55%). The catheter could be seen in the third part of duodenum only in 9 cases (45%). The mean placement procedure lasted (20.35±12.93) minutes for the successful cases. The time spent in the 11 patients with empty stomach was (15.00±9.87) minutes, less than (26.89±14.45) minutes in those 9 post prandial patients (P＜0.05). ConclusionsWith stylet displacement to determine the location of the catheter, sonography guided Freka Trelumina placement has a high success rate. Ultrasonic guidance facilitates the insertion of the tubes in critically ill patients. For patients with empty stomach, it may help reduce the operating time.