上消化道肿瘤病人围手术期内镜辅助置入鼻空肠营养管的不同方法比较  

Endoscopically assisted nasojejunal feeding tube placing in patients with upper gastrointestinal caner perioperatively: comparison of different approaches

作　　者：闫炎[1] 吴齐[1] 

机构地区：[1]北京大学肿瘤医院内镜中心,北京100083

出　　处：《肠外与肠内营养》2014年第4期241-243,246,共4页Parenteral & Enteral Nutrition

摘　　要：目的:比较三种内镜辅助下置入鼻空肠营养管对上消化道肿瘤病人围手术期的应用价值。方法:对127例行内镜辅助下鼻空肠营养管置入术进行肠内营养(EN)支持病人的临床资料进行回顾性分析,其中经鼻胃镜下导丝引导置入鼻空肠营养管44例,经口胃镜下直视钳夹置入鼻空肠营养管41例,经口胃镜下导丝引导置入鼻空肠营养管42例。结果:127例病人中,鼻胃镜导丝引导下置管成功率为97.7%(43/44),平均放置时间为(10.16±5.31)min。经口胃镜下直视钳夹置管成功率97.5%(40/41),平均放置时间为(16±5.11)min。经口胃镜导丝引导置管成功率为97.6%(41/42),平均放置时间为(20.95±3.31)min。三种方法置管时间差异有统计学意义。经鼻胃镜导丝引导下放置鼻空肠营养管置管时间短,无严重并发症,病人耐受良好。结论:经鼻胃镜导丝引导下放置鼻空肠营养管方法便捷、可靠、病人耐受性好。Objective：Nutrional support is important and necessary for patients who cannot maintain their needs with oral intake.Enteral nutrition is the preferred means of nutrient delivery especially for those with tumors of upper digestive tract.Nasoenteric feeding tubes are common used,and most of the tubes are placed by endoscopic devices clinically.Wesummarized the experience of placing nasal jejunum nutrition tube,and compared the difference of placing the tube using transnasal gastroscope or normal gastroscope.Methods：127 patients who needed establishing enteral nutrition access were randomly separated into 3 groups.In one group,tubes were placed with the assistance of transnasal gastroscope and guide wire,while in the other 2 groups tubes were placed using normal gastroscope with forceps,with or without guide wires.Results：43 of 44 cases were successfully placed nasal jejunum nutrition tube by transnasal gastroscope,success rate was 97.7％,the average time was （10.16 ± 5.31） min,and no perforation and hemorrhage occurred.The patients were well tolerated during the process.The time of the normal gastroscope group was （16 ± 5.11）min and （20.95 ± 3.31）min,and the success rate was 97.5 ％ and 97.6％,with or without guide wires separately.Conclusion：It is a reliable,convenient and welltolerated method to place nasal jejunum nutrition tube by transnasal gastroscope.

关 键 词：上消化道肿瘤病人 经胃镜置入空肠营养管 肠内营养支持 

分 类 号：R735[医药卫生—肿瘤] R459.3[医药卫生—临床医学]