改良鼻胆管固定方式改善右卧患者睡眠及预防非计划拔管的作用
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Effects of an Improved Nasobiliary Tube Fixation Method on Sleep Quality and Prevention of Unplanned Tube Removal in Patients Sleeping in the Right Lateral Position
XU Wenchao1 ，XIAO Zhe²，WANG Zhaotai²
（ I Department of General Surgery，Qilu Hospital of Shandong University，Ji'nan 2500l2，China; 2 Department of Emergency Medicine，Qilu Hospital of Shandong University，Ji'nan 25ool2，China）
AbstractObjective：Toinvestigate theefects of animproved nasobiliarytubefixation methodonsleepqualityandthe preventionofunplannedtuberemoval inpatientshohabituallsleepinterightlteralposition.Methods：Aretrospectiveanalysiswas conductedon1OOpatientsadmitedtotheDepartmentofGeneralSurgeryofQilu HospitalofShandong UniversitybetweenDecember2023andApril2O25whohabituallysleptintherightlateralpositionandunderwentendoscopicnasobiliarydrainage.Acording todiferentnasobiliarytubfixation methods，patients were divided intoacontrol groupandanobservationgroup， with 50 cases in each group.The control group received the conventional right-sided short single-reverse α fixation method，while the observation group received the left-sided short single-reverse α fixation method. Patient comfort was assessed using the Kolcaba General Comfort Questionnaire（GCQ）.Changes inslepqualitybeforeandafter intervention wereevaluated usingthePitsburgh SleepQualityIndex（PSQI），and improvement ininsomniaseveritywasassesedusing the Insomnia SeverityIndex（ISI）. Polysomnographywasused to monitorchanges insleeparchitecture-related parameters.Theincidenceofunplanned tuberemoval during hospitalizationwasalsorecorded.Results：Afterintervention，theobservationgroupshowedsignificantlyhigherphysiologicaland psychospiritualscoresontheGCQcomparedwith thecontrolgroup.ThePSQIandISIscores，aswellastheincidenceof unplanedtuberemoval，weresignificantlylowerintheobservationgroupthaninthecontrolgroup.Alldiferencesetweenthe two groups were statistically significant（ P<0.05 ）. Conclusion：For patients who habitually sleep in the right lateral position and undergo endoscopic nasobiliary drainage，fixation of the nasobiliary tube using the left-sided short single-reverse α method can improve comfort and sleep quality and effectively prevent unplanned tube removal.
KeywordsEndoscopy；Nasobiliarydrainage；Tubefixationmethod；Sleepingposition；Rightlateralposition；Sleepquality;
Comfort;Unplanned tuberemoval
中图分类号：R657.4;R338.63 文献标识码：A doi：10.3969/j.issn.2095-7130.2025.12.001
内镜鼻胆管引流术在胆总管结石、化脓性胆管炎、胆漏等疾病的治疗中得到广泛应用[1]。（剩余5369字）