The Study On Nasointestinal Tube Placement By Ultrasound Guidance And Improved Intragastric Air Injection In Severe Trauma Patients

Background:International guideline recommended that early enternal nutrition is benefit for improving the patient condition and prognosis. Post-pyloric nutrition has many advantages, such as good tolerance, low regurgitation rate, high nutrition absorption and less complication. But how to place the post-pyloric feeding tube is still a major problem in critical medicine.Objectives:Apply improved intragastric air injection in the placement of nasointestinal tube under the guidance of ultrasound in severe trauma patients to explore a new effective way to establish early post-pyloric enternal nutrition.Methods:A total of200severe trauma patients with the need of early enternal nutrition in Emergency Intensive Care Unit were enrolled and divided into research group(n=100) and control group(n=100) randomly. For research group, the nasointestinal tube was placed by using improved gastric insufflations and under the guidance of ultrasound. While for control group, it was placed blindly. Assess the rate of successful postpyloric placement on the day of placement, three days and seven days after placement, the duration for passing the pylorus, the time to start enternal feeding, the time to reach nutrition target, the complication during tube placement.Results:1. The rate of successful postpyloric placement on the day of placement, three days and seven days after placement in research group were significantly higher than control group (90/100VS41/100:P<0.05;92/100VS59/100:P<0.05;98/100VS88/100:P<0.05)2. The feeding rate in the first day, within three days and seven days after tube replacement were higher than control group obviously (37/100VS13/100:P<0.01;70/100VS48/100:P<0.01;100/100VS89/100:P<0.01)3. There was no difference in the complications during tube placement between two groups (P>0.05).4. There was no difference in the prognosis between two groups (P>0.05).Conclusions:The research finds that it is valuable to apply gastric gas injection and ultrasonic guidance in the nasointestinal tube placement. As a new placement method, ultrasonic guiding can monitor the position of the head of the tube so as to shorten the time for placement and improve the rate of successful postpyloric placement. So enternal nutrition can be establshed as early as possible.