摘要
目的探讨床边胃镜引导下鼻肠管置入术对重型颅脑损伤伴胃瘫患者进行肠内营养的临床应用价值。方法选择我科收治的重型颅脑损伤伴胃瘫患者71例,先将鼻空肠营养管经鼻插入胃腔内,再置入胃镜,在胃镜下用异物钳钳夹胃腔内的鼻肠营养管,将其送至Treitz韧带以下,建立肠内营养通道。结果 71例重型颅脑损伤伴胃瘫患者一次性置管成功率100%。其中1例并发上消化道出血,无穿孔及误入气管患者。2例术中出现全身强直、心率增快,1例出现心率减慢、血压下降,经处理均于术后2h内好转。置管成功后无胃肠内容物反流;无一例出现营养管滑脱。结论床边胃镜引导下鼻肠管置入术对重型颅脑损伤患者建立有效的肠内营养途径,操作技术简单,成功率高,并发症少,安全可靠,值得临床推广。
Objective To study the clinical application value of bedside gastroscope-directed placement of nasointestinal tube to perform early enteral nutrition for patients with severe head injury complicated by gastroplegia.Methods Totally 71 inpatients with severe head injury complicated by gastroplegia were included.Firstly,nasointestinal tube was placed into the stomach via the nose.Secondly,gastroscope was inserted.Then the nasointestinal tube was clamped by a foreign body corceps under the gastroscope and it was sent down into the jejunum below the ligament of Treitz,and thus enteral nutrition tunnel was established.Results For all the 71 cases nasointestinal tube was successfully placed at one time.Among them one patient had a complication of upper gastrointestinal hemorrhage;no case of perforation or intubation misled into the trachea was found;and two patients who had general convulsion and tachycardia and one patient who had bradycardia with decrease of blood pressure got improved 2 hours after operation through appropriate treatment.No reflux of gastric contents occurred after establishment of enteral nutrition tunnel or slippage of tube occurred.Conclusion Bedside gastroscope-directed placement of nasointestinal tube is a good method to perform early enteral nutrition for patients with severe head injury complicated by gastroplegia.Its is simple in operation,higher in success rate,and lower in complication,so it is worth of generalization in clinic.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第27期3109-3110,共2页
Chinese General Practice
基金
浙江省温州市科技局资助项目(Y20070105)
关键词
颅脑损伤
胃镜
肠道营养
Craniocerebral trauma
Gastroscopes
Enteral nutrition
