鼻胃管留置对心脏大血管手术患者术后肺部并发症及预后的影响

doi:10.3761/j.issn.0254-1769.2021.12.003

摘要/Abstract

摘要：

目的探讨鼻胃管留置对心脏大血管手术患者术后肺部并发症及预后的影响,旨在降低术后肺部并发症的发生率,改善患者预后结局。方法回顾性收集2018年7月—2019年11月武汉市某三级甲等医院行心脏大血管手术患者的一般信息和临床资料,根据是否留置鼻胃管分为留置鼻胃管组和未留置鼻胃管组,进行倾向性评分匹配后对两组术后肺部并发症的发生情况及预后等进行比较。结果经过倾向性评分匹配,留置鼻胃管组和未留置鼻胃管组各纳入158例。与未留置鼻胃管组相比,留置鼻胃管组肺部感染、肺不张、气胸、呼吸衰竭的发生率均较高,总住院时长和ICU住院时长较长,转归较差,差异均具有统计学意义（P<0.05）。结论鼻胃管留置会增加心脏大血管手术患者术后肺部并发症的发生,且会延长患者住院时间,影响患者预后结局。

关键词: 鼻胃管, 术后肺部并发症, 心脏大血管外科, 预后, 围手术期护理

Abstract:

Objective To investigate the effects of nasogastric tube（NGT） indwelling on postoperative pulmonary complications（PPCs） and prognosis in patients with cardiovascular surgery,in order to reduce PPCs and improve the patients’ prognoses. Methods Retrospective data of patients undergoing cardiovascular surgery in a tertiary hospital in Wuhan from July 2018 to November 2019 was conducted. The baseline data of patients in 2 groups were matched using a propensity score analysis. Results 316 patients were successfully matched,with 158 patients in the nasogastric tube indwelling group and 158 patients in the non-indwelling group. Compared with the patients in the NGT group without indwelling,the incidence of pulmonary infection,atelectasis,pneumothorax and respiratory failure was higher in the NGT group;the length of stay in the hospital and the length of stay in ICU were longer;the outcome was poor,with statistically significant differences（P<0.05）. Conclusion NGT indwelling is associated with the occurrence of pulmonary complications in patients with cardiovascular surgery,and it might prolong the length of stay and affect patient’s outcome.

Key words: Nasogastric Tube, Postoperative Pulmonary Complications, Cardiovascular Surgery, Prognosis, Perioperative Nursing

胡凯利, 周雁荣, 李冰冰, 吴前胜, 张严丽, 陈莹莹, 陈钊. 鼻胃管留置对心脏大血管手术患者术后肺部并发症及预后的影响[J]. 中华护理杂志, 2021, 56(12): 1778-1782.

HU Kaili, ZHOU Yanrong, LI Bingbing, WU Qiansheng, ZHANG Yanli, CHEN Yingying, CHEN Zhao. The effect of nasogastric tube on postoperative pulmonary complications and prognosis in patients undergoing cardiovascular surgery[J]. Chinese Journal of Nursing, 2021, 56(12): 1778-1782.

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