基于“R-S-A”三点位在危重症患者超声引导下鼻肠管置入技术的初步探索

陈双梅; 刘若萱; 谭亮; 苏小洪; 刘美麟; 齐俊生; 曹英

doi:10.16016/j.2097-0927.202403009

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基于“R-S-A”三点位在危重症患者超声引导下鼻肠管置入技术的初步探索

临床医学 | 更新时间：2026-01-09

- 基于“R-S-A”三点位在危重症患者超声引导下鼻肠管置入技术的初步探索
- Efficacy of ultrasound-guided nasointestinal tube placement technique based on the "R-S-A" 3-point positioning in critically ill patients
- 陆军军医大学学报 2024年46卷第18期页码：2145-2151
- 作者机构：
  
  400038 重庆, 陆军军医大学第一附属医院重症医学科
- 作者简介：
  
  [曹英, E-mail: caoying123@tmmu.edu.cnCAO Ying, E-mail: caoying123@tmmu.edu.cn
- 基金信息：
- DOI：10.16016/j.2097-0927.202403009
  中图分类号： R445.1;R459.3;R472.9
- 收稿：2024-03-04，
  
  修回：2024-05-08，
  
  纸质出版：2024-09-30
- 稿件说明：
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陈双梅, 刘若萱, 谭亮, 等. 基于“R-S-A”三点位在危重症患者超声引导下鼻肠管置入技术的初步探索[J]. 陆军军医大学学报, 2024,46(18):2145-2151.

Shuangmei CHEN, Ruoxuan LIU, Liang TAN, et al. Efficacy of ultrasound-guided nasointestinal tube placement technique based on the "R-S-A" 3-point positioning in critically ill patients[J]. Journal of Army Medical University, 2024, 46(18): 2145-2151.
陈双梅, 刘若萱, 谭亮, 等. 基于“R-S-A”三点位在危重症患者超声引导下鼻肠管置入技术的初步探索[J]. 陆军军医大学学报, 2024,46(18):2145-2151. DOI： 10.16016/j.2097-0927.202403009.

Shuangmei CHEN, Ruoxuan LIU, Liang TAN, et al. Efficacy of ultrasound-guided nasointestinal tube placement technique based on the "R-S-A" 3-point positioning in critically ill patients[J]. Journal of Army Medical University, 2024, 46(18): 2145-2151. DOI： 10.16016/j.2097-0927.202403009.

摘要

目的

本研究旨在借助超声可视化特点，结合“R-S-A”三点位行危重症患者超声引导下鼻肠管置入，并评估此技术的精准度、有效性。

方法

对重庆市某三级甲等医院重症医学科2022年4月-2023年8月收治的全部危重症鼻肠管置管患者进行回顾性分析。根据置管体位分为对照组与观察组，对照组行超声引导下鼻肠管置入，观察组在超声引导的基础上以“R-S-A”三点站位(患者取右侧卧位，置管者站于患者右肩处，超声操作者站于右腹部操作方向)行超声引导下鼻肠管置入，对照组仅在超声引导下行鼻肠管置入，对体位无特殊要求。倾向性评分匹配后比较两组的置管时间、置管成功率、并发症发生情况。

结果

观察组平均置管时间(36.2±10.3)min短于对照组(42.3±8.3)min，置管成功率95.2%高于对照组66.7%，差异均具有统计学意义(

0.05)。观察组并发症发生率9.5%少于对照组28.6%，但

0.05，差异无统计学意义。

结论

基于“R-S-A”三点位行危重患者超声引导下鼻肠管置入技术精准度高、有效性强，能够缩短置管时间，提高置管成功率。

Abstract

Objective

To evaluate the precision and effectiveness of ultrasound-guided visualization for nasojejunal tube placement with the "R(right reclining)-S(shoulder)-A(abdominal)" 3-point positioning for critically ill patients.

Methods

A retrospective analysis was conducted on all critically ill patients who underwent nasojejunal tube placement in Department of Critical Medicine of a tertiary hospital in Chongqing from April 2022 to August 2023. According to the position of the catheter

they were divided into a control group and an observation group. The control group received ultrasound-guided nasojejunal tube insertion

while the observation group used the "R-S-A" 3-point positioning (the patient were placed in a right lateral position

the nurse stood at the right shoulder of the patient

and the ultrasound operator stood on the right side of the abdomen in the operating direction) for ultrasound-guided nasojejunal tube insertion. And

the control group had no specific requirements for positioning during the procedure. After propensity matching

the time and success rate of catheter insertion and incidence of complications were compared between the 2 groups.

Results

The time of catheter insertion was significantly shorter (36.2±10.3

42.3±8.3 min)

and the success rate of insertion was obviously higher (95.2%

66.7%) in the observation group when compared with the control group (

0.05). The incidence of complication was 9.5% in the observation group

and

28.6% in the control group

but there was no statistical difference between the 2 groups.

Conclusion

Ultrasound-guided nasojejunal tube placement based on "R-S-A" 3-point positioning has high precision and strong effectiveness in critically ill patients

which can shorten the time and improve the success rate of catheter insertion.

关键词

Keywords

references

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