摘要
目的探讨在重症患者中胃镜辅助下以鼻胃管代替普通鼻肠管实施肠内营养的安全性和可靠性。方法选择需要肠内营养重症患者70例,分为胃管代鼻肠管组和螺旋型鼻肠管组,每组35例。胃管代鼻肠管组在胃镜下用异物钳钳夹鼻胃管,推送胃镜和异物钳经过幽门,尽可能送胃管达幽门以远。螺旋型鼻肠管组鼻肠管远端未在小肠者,借助胃镜完成。结果此种胃镜下胃管代鼻肠管方法营养管放置成功率为100%。放置期间均无并发症。在使用过程中有2例出现反流,胃镜检查发现1例营养管易位于胃腔,另1例位置正常。吸入性肺炎发生率为5.7%;肠内营养期间未发生堵管现象。肠内营养支持治疗后患者营养参数有改善(P<0.05)。结论胃镜下用胃管代替普通鼻肠管进行肠内营养具有安全可靠、不易堵管、反流率低的优点。
[Objective] To observe the safety and effectiveness of enteral feeding tube as nasogastric tube instead of common nasointestenal tube with the help of endoscopy in the critical patients.[Methods] 70 cases of critical patients who received enteral nutrition by postpyloric feeding tube,were divided into naso-gastric tube group and spiral naso-intestinal tube group.Each group was consisted of 35 cases.In naso-gastric group,naso-gastric tube instead of naso-intestinal tube,the feeding tubes were placed with endoscopy.With the guidance of endoscopy,the pincers grasped the end of the nasogastric tube,and sent it into the pylorus,as far as possible.[Results] The success rate of such method which placed the naso-pyloric feeding tube with the guidance of endoscopy was 100%.There were no complications during the procedure.The feeding tube displaced into the stomach in 2 cases during the enteral nutrition,reflux in 2 cases,aspiration pneumonia 2 cases,no blockage of all feeding tubes.[Conclusion] Naso-gastric tube instead of common naso-intestinal tube,which was placed beyond postpylorus as naso-postpyloric feeding tube,was safe and effective,not prone to blockage,less reflux during enteral nutrition.
出处
《中国内镜杂志》
CSCD
北大核心
2012年第10期1033-1037,共5页
China Journal of Endoscopy
关键词
鼻胃管
鼻肠管
重症
胃镜
naso-gastric tube
naso-intestinal tube
critical patients
gastroscope
