胃镜辅助放置鼻胃管和空肠营养管  

Endoscopically assisted nasogastri tube and nasojejunal tube placement

作　　者：欧希龙[1] 孙为豪[2] 曹大中[1] 俞谦[1] 俞婷[1] 产松苗[1] 陈国胜[1] 颜芳[1] 张有珍[1] 吴自英[1] 刘顺英[1] 

机构地区：[1]东南大学附属中大医院消化科,江苏省南京市210009 [2]南京医科大学附属第一医院老年医学科,江苏省南京市210009

出　　处：《世界华人消化杂志》2007年第6期655-658,共4页World Chinese Journal of Digestology

摘　　要：目的:探讨胃镜下放置鼻胃管和空肠营养管建立肠内营养途径的方法.方法:11例鼻胃管,其中8例患者在胃镜下用异物钳钳夹鼻胃管推送胃镜将其送至胃腔,3例在胃镜下放入导丝,通过导丝放入鼻胃管.46例空肠营养管,在胃镜下用异物钳钳夹胃腔内空肠营养管,推送胃镜将其送至Treitz韧带以下.结果:胃镜下11例鼻胃管全部放置成功.通过改良胃镜直接置管方法,空肠营养管放置成功率例为100%,其中鼻肠管29例,三腔鼻肠管17例.鼻肠管弯曲,折回,打圈7例,后退鼻肠管头端重新放置成功,退出胃镜后鼻肠管脱出3例,改进方法后,2例2次,1例3次放置成功.1例胰腺炎置管后血淀粉酶增高.结论:对常规放置困难的鼻胃管,胃镜下放置简单可行.改良方法后可一次使空肠营养管头端到达空肠,此方法副作用小,成功率高,操作技术简单安全.AIM： To investigate the path of enteral nutrition by endoscopic placement of nasogastric or nasojejunal tubes. METHODS： The nasogastric tubes were placed in the gastric cavity of 8 patients by pushing endoscope after being clipped by foreign body forceps, and 3 patients by guide wire. Clipped by foreign body forceps, the nasojejunal tubes were placed in 46 patients by pushing endoscopy through the Treitz ligament. RESULTS： Nasogastric tubes placement were performed successfully in all the 11 patients. The success rate of nasojejunal tube placement was also 100% after using modified methods. Of the 46 cases, 29 received nasointestinal tgbes while 17 received triple-lumen tubes. Curvature,snaping-back and looping occurred in 7 cases, but the tubes were re-placed successfully after backing off. When the endoscope was retired, 3 nasointestinal tubes dropped off. The placement was performed successfully with a modified method in 2 cases at the 2^nd time and 1 case at the 3^rd time. There were no severe complications. The level of amylase rose in only 1 case after placement. CONCLUSION： Endoscopic placement of nasogastric tubes is simple, feasible, and suitable for the patients difficult to be placed by routine method. The modified method can achieve onetime placement of nasointestinal tube under Treitz ligament with less side effect and high success rate.

关 键 词：胃镜 空肠营养管 鼻胃管 置管方法 

分 类 号：R401[医药卫生—临床医学]