改良内镜下鼻空肠管置管术在儿科疾病中的应用  

Application of modified endoscopic nasojejunal catheterization in pediatric diseases

作　　者：陈峻[1] 杨建[1] 王明英[1] 刘四香 杨智宽[1] 杨丽红 段金涛 CHEN Jun;YANG Jian;WANG Mingying;LIU Sixiang;YANG Zhikuan;YANG Lihong;DUAN Jintao(Department of Gastroenterology,Kunming Municipal Children′s Hospital,Kunming,Yunnan 650229,China)

机构地区：[1]云南省昆明市儿童医院消化科,650229

出　　处：《重庆医学》2022年第9期1540-1544,共5页Chongqing medicine

基　　金：云南省卫生科技计划项目(2018NS0171);中华消化内镜创新发展项目(Z-2019-45-2001);云南省昆明市科技计划项目(2019-1-S-25318000001092)。

摘　　要：目的观察改良内镜下鼻空肠管置管术在儿科疾病中的应用效果,并与传统内镜下鼻空肠管置管术进行比较。方法将2017年12月至2020年12月昆明市儿童医院收治的需放置鼻空肠管的患儿104例,采用随机数字表法分为对照组(n=52)和观察组(n=52),对照组行传统内镜下鼻空肠管置管术,观察组行改良内镜下鼻空肠管置管术,比较两组置管花费时间、置管维持时间及一次性置管成功率、并发症发生率,比较置管前和置管1周、3周、5周后的清蛋白、总蛋白、前清蛋白、免疫球蛋白(Ig)A、IgG、IgM水平。结果观察组置管花费时间显著低于对照组(P<0.05);观察组置管维持时间、并发症发生率与对照组比较差异无统计学意义(P>0.05);观察组一次性置管成功率(96.15%)显著高于对照组(80.77%),二者比较差异有统计学意义(P<0.05)。置管前,两组清蛋白、总蛋白、前清蛋白、IgA、IgG、IgM水平差异无统计学意义(P>0.05);置管1周、3周、5周后,两组清蛋白、总蛋白、前清蛋白、IgA、IgG、IgM水平较置管前显著升高(P<0.05),观察组清蛋白、总蛋白、前清蛋白、IgA、IgG、IgM水平与对照组比较差异无统计学意义(P>0.05)。结论改良内镜下鼻空肠管置管术在儿科疾病中的应用效果较好,能将置管花费时间缩短,提高一次性置管成功率,减少并发症发生率,且在营养水平及免疫指标改善方面有所获益。Objective To observe the application effect of modified endoscopic rhinojejunal catheterization in pediatric diseases,and to compare it with traditional endoscopic nasojejunal catheterization.Methods A total of 104 children patients needing to put nasojejunal catheter in this hospital from December 2017 to December 2020 were prospectively divided into the control group(n=52)and observation group(n=52)according to the random number table method.The control group underwent the traditional endoscopic nasojejunal catheterization.The observation group underwent the modified endoscopic nasojejunal catheterization.Then the catheterization time,catheterization maintenance time,once success rate and complication occurrence rate were compared between the two groups.The levels of albumin,total protein,prealbumin,immunoglobulin A,IgG and IgM before catheterization and in 1,3,5 weeks after catheterization were compared between the two groups.Results The catheterization time in the observation group was significantly lower than that in the control group(P<0.05);the catheterization maintenance time and complication occurrence rate had no statistically significant difference between the two groups(P>0.05);the once success rate of the observation group was significantly higher than that of the control group(96.15%vs.80.77%,P<0.05).Before the catheterization,there was no statistically significant difference in the levels of albumin,total protein,prealbumin,IgA,IgG and IgM between the two groups(P>0.05);in 1,3,5 weeks after catheterization,the levels of albumin,total protein,prealbumin,IgA,IgG and IgM in the two groups were significantly higher than those before the catheterization(P<0.05).there were no statistically significant differences in the levels of albumin,total protein,prealbumin,IgA,IgG and IgM between the observation group and the control group(P>0.05).Conclusion The application of improved endoscopic nasojejunal catheterization in pediatric diseases has good effect,can shorten the catheterization time,increase the once

关 键 词：内镜下鼻空肠管置管术 肠内营养 儿科疾病 应用效果 

分 类 号：R726.5[医药卫生—儿科]