| Purpose The purpose of this study is to explore the method of measuring the appropriate nasogastic tube depth in bedridden patients and to provide a basis for the appropriate depth of clinical nasogastic tube implantation to meet the different needs of patients with enteral nutrition,administration and gastrointestinal decompression,and reduce the occurrence of complications.Methods The study select subjects from December 2016 to December 2017 in the first People's Hospital in Changshu using nasogastric tube catheterization,the use of convenient sampling method,the selection of 60 patients with the inclusion criteria,the preoperative measurement of patient NEX(Nose-ear-xiphisternum)length and GWNUF[(method using gender,weight)and(nose to the umbilicus with the adult's head flat on the bed)]length.The CH/FR15,100 cm,F/TR nasogastric tube was used to place the tube into the expected depth and the bedside film was confirmed after the gastric tube was in place.After the film was recorded the lenth of the tube tip and the guide wire tip to the cardia of stomach,then adjust the tube to the stomach tube tip and all the lateral foramen into the stomach.At this time the depth of the nasal stomach was recorded as the standard depth,and measure the length of tube tip from the lowest position of the antrum,the standared depth compared with eight species(A1:NEX;A2:NEX+8cm;A3:NEX+10cm;A4:NEX+12cm;B1:GWNUF;B2:GWNUF+8cm;B3:GWNUF+10cm;B4:GWNUF+12cm).Compare the ratio of the tip into the stomach,the ratio of all the lateral foramen of the nasal canal to e stomach,the tip of the tube to the gastric sinus and the excessive length of the tube.Results 1.The depth of nasogastric tube(1)The reference depth of nasogastric tube after the catheter adjustment is :59.93±4.92cm?(2)The average length of the four A1-A4 measurement methods is shown as follows: 54.92±3.411 cm,62.92±3.411 cm,64.92±3.411 cm,66.92±3.411 cm.(3)The average length of the four B1-B4 measurement methods is shown as follows:53.13±2.121 cm,61.13±2.121 cm,63.13±2.121 cm,65.13±2.121cm?(4)The average length of the tip of the A1-A4 into the stomach is shown as follows: 4.99±3.012 cm,12.99±3.012 cm,14.99±3.012 cm,16.99±3.012 cm,The average length of the tip of the B1-B4 into the stomach is shown as follows: 3.21±4.266 cm,11.21±4.266 cm,13.21±4.266 cm,15.21±4.266cm?(5)Make the tip of the tube and all the side holes into the stomach,and the average length of A1-B4 is shown as follows: 5.011±3.012 cm,-2.99±3.012 cm,-4.99±3.012 cm,-6.99±3.012 cm,6.88±4.09 cm,,-1.21±4.266 cm,-3.21±4.266 cm,-5.21±4.266cm? 2.Comparison of nasogastric tube tip entry rate in eight kinds of catheter methods The nasogastric tube tip entry rate in eight kinds of catheter methods,from A1 to B4 as follow: 98.33%,100%,100%,100%,75%,100%,100%,100%?Andthe difference is statistically significant(X2=100.345,P<0.001).what's more,B1(GWNUF)comparison with other seven methods,the difference is statistically significant;Compared to the other seven methods,there was no statistical difference between the groups.3.Comparison of the ratio of all the apical and lateral foramen of nasogastric tube into the stomach in eight kinds of catheterization methods The ratio of all the apical and lateral foramen of nasogastric tube into the stomach in eight kinds of catheterization methods from A1 to B4 is shown as follow:11.67%,90.00%,98.33%,100%,5.00%,61.67%,80%,80%?The highest rate is A4,the lowest rate is B1.After overall comparison,the difference is statistically significant(X2=263.044,P<0.001).Further pairwise comparison,there was no statistical difference between A1 d B1,compared with other methods,there were statistical differences(P<0.0018).Compared with A2 and A3?A4?B3?B4,there were no statistical difference(P>0.0018),compared with the other methods,there is a statistical difference(P<0.0018);compared with A3 and A2 ? A4,there were no statistical difference(P >0.0018),compared with the other methods,there is a statistical difference(P <0.0018);compared with A4 and A2?A3,there were no statistical difference(P>0.0018),compared with the other methods,there is a statistical difference(P <0.0018);there was no statistical difference between B1 and A1,compared with the other methods,there is a statistical difference(P<0.0018);compared with B2 and B3?B4,there were no statistical difference(P>0.0018),compared with the other methods,there is a statistical difference(P<0.0018);compared with B3 and A2?B2?B4,there were no statistical difference(P>0.0018),compared with the other methods,there is a statistical difference(P<0.0018);compared with B4 and A2?B2?B3,there were no statistical difference(P>0.0018),compared with the other methods,there is a statistical difference(P<0.0018).4.Comparison of the rate of the tip of the nasogastric tube into the antrum of the eight catheterization methods The rate of the tip of the nasogastric tube into the antrum of the eight catheterization methods from A1 to B4 is shown as follow : 5.00 %,8.33%,60.00 %,40%,1.67%,36.67%,51.67%,55%? The highest ratio is A3,the lowest ratio is B1.After overall comparison,the difference is statistically significant(X2=95.894,P<0.001).Further pairwise comparison,there was no statistical difference between A1 and B1(P>0.0018),compared with the other methods,there is a statistical difference(P<0.0018);there are statistical difference between A2 ?A3?A4 ?B2?B3?B4 and A1?B1,compared with the other methods,there were no statistical difference.5.Comparison of the ratio of nasogastric tube over-length in eight catheterization methods In addition to A1 and B1,the other six catheterization methods have some degrees of excessive phenomenon,some reflexive,twist,fold,and some enter the post-pyloric digestive tract.The over-lenghth ratios of the six tube placement methods is shown as ollow : A2(NEX+8)13.33%;A3(NEX+10)28.33%;A4(NEX+12)60%;B2(GWNUF+8)6.67%;B3(GWNUF+10)20.00%,B4(GWNUF+12)20.00%?After overall comparison,the difference is statistically significant(X2=106.251,P<0.001).Further pairwise comparison,there is a statistical difference between A1 and A3?A4?B3?B4(P<0.0018),compared with the other methods,there was no statistical difference(P>0.0018);there is a statistical difference between A2 and A1?A4(P<0.0018),compared with the other methods,there was no statistical difference(P>0.0018);there is a statistical difference between A3 and A1?A4?B1(P<0.0018),compared with the other methods,there was no statistical difference(P>0.0018);there is a statistical difference between A4 and other method(P<0.0018);there is a statistical difference between B1 and A3?A4?B3?B4(P<0.0018),compared with the other methods,there was no statistical difference(P>0.0018);there is a statistical difference between B2 and A4(P<0.0018),compared with the other methods,there was no statistical difference(P>0.0018);there is a statistical difference between B3?B4 and A1?A4?B1(P<0.0018),compared with the other methods,there was no statistical difference(P>0.0018).Conclusion 1.Except for GWNUF catheterization,the other seven catheterization methods can be used for the tube placement of the nasogastric tube without lateral orifice,but only for nasal feeding or administration,not for gastrointestinal decompression.2.NEX catheterization is not suitable for gastric tube insertion with lateral foramen and cannot be used in patients with enteral nutrition and gastrointestinal decompression.3.The GWNUF intubation method is contrary to the foreign research conclusions and is not suitable for the nasogastric tube placement of the Chinese people.4.Prolonged 8-10 cm based on NEX was used for nasogastric tube placement in patients requiring enteral nutrition and gastrointestinal decompression. |
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