新型胆-肠营养管的设计及应用  

Design and application of a new type of biliary-intestinal nutrient tube

作　　者：曹建华[1] 王胜[1] 姚建军[1] 马金莲[1] 李海明 穆占虎 陈劼 Cao Jianhua;Wang Sheng;Yao Jianjun;Ma Jinlian;Li Haiming;Mu Zhanhu;Chen Jie(Department of Hepatobiliary Surgery,First People's Hospital of Yinchuan,Yinchuan 750001,Ningxia Hui Autonomous Region,China)

机构地区：[1]银川市第一人民医院肝胆外科,宁夏银川750001

出　　处：《中华危重病急救医学》2022年第7期762-763,共2页Chinese Critical Care Medicine

基　　金：宁夏回族自治区重点研发计划项目(2021BEG03080)。

摘　　要：建立营养通路是恶性肿瘤患者实施营养治疗的前提和基础。鼻胃管、鼻肠管和经皮内镜下胃/空肠造口是临床上常用的肠内营养(EN)通路。当恶性梗阻性黄疸(MOJ)患者合并幽门或十二指肠起始段梗阻时,上述EN通路通常难以建立。为此,银川市第一人民医院肝胆外科医护人员设计了一种可经"经皮肝穿刺胆道引流术(PTCD)"通路放置的新型胆-肠营养管,解决了上述难题,并获得了国家实用新型专利(专利号:ZL 202020283951.5,ZL 202020288938.9)。新型胆-肠营养管有双腔管和单腔管两种类型,由管头、管体、尾环和显影环组成。双腔管管体双腔道设计实现了胆汁内引流与EN同步实施;单腔管用于胆管金属支架置入术后的营养液输注,可不受营养液类型限制。两种营养管的尾环均置于空肠上段,可减少逆行感染和意外脱管。与现有技术相比,本实用新型专利结构简单、设计合理,经PTCD通路放置安全、有效,为MOJ患者开辟了一条新的EN通路。The establishment of a nutritional pathway is the premise and basis of nutritional therapy for patients with malignant tumor.The nasogastric tube,nasoenteric tube,and percutaneous endoscopic gastric/jejunostomy are commonly used clinical pathways for enteral nutrition(EN)therapy.However,these EN pathways are often difficult to establish in patients with malignant obstructive jaundice(MOJ)with pyloric or duodenum primary obstruction.For this reason,a new type biliary-intestinal nutrient tube placed through percutaneous transhepatic cholangiography drainage(PTCD)pathway was designed by the medical staff of hepatobiliary surgery department of Yinchuan First People's Hospital,and National Utility Model Patent of China were obtained(ZL 202020283951.5,ZL 202020288938.9).The new biliary-intestinal nutrient tube has two types:double-lumen tube and single-lumen tube,which consists of tube head,tube body,tail ring and developing ring.The double lumen tube realizes bile internal drainage and EN simultaneously through the double lumen structure of the tube body.The single-lumen tube is used for nutrient infusion after bile duct metal stent implantation,which is not limited by the type of nutrient solution.The tail ring of the two types of nutrient tube is placed in the upper jejunum to reduce retrograde infection and unexpected extubation.Compared with the prior art,the utility model has the advantages of simple structure,reasonable design,safe and effective placement through PTCD pathway,and opens up a new EN path for MOJ patients.

关 键 词：肠内营养 肠内营养通路 经皮肝穿刺胆道引流术 设计 应用 

分 类 号：R197.39[医药卫生—卫生事业管理]