以中心静脉导管辅助胃腔充气后CT引导下经皮穿刺胃造瘘术  

CT-guided percutaneous gastrostomy under central venous catheter assisted gastric lumen insufflation

作　　者：黄志成[1] 张帅[1] 郑君[1] 杨磊[1] 张苏雅 吴佳妮 王冰[2] WU Jiani;WANG Bing(Department of Radiology,Jilin Cancer Hospital,Changchun 130021,China;Department of Radiotherapy,Jilin Cancer Hospital,Changchun 130021,China)

机构地区：[1]吉林省肿瘤医院放射线科,吉林长春130021 [2]吉林省肿瘤医院放疗科,吉林长春130021

出　　处：《中国介入影像与治疗学》2023年第9期536-539,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的观察对无法经口插管胃腔充气患者以中心静脉导管辅助胃腔充气后行CT引导下经皮穿刺胃造瘘术的可行性。方法回顾性分析26例无法经口插管入胃腔内进行充气的下咽癌或食管癌患者,均于采用中心静脉导管套件建立经皮穿刺充气通路对胃腔进行充气后行CT引导下经皮穿刺胃造瘘术,观察其成功率及并发症。结果26例CT引导下经皮穿刺胃造瘘术均获成功;操作时间15~45 min,平均(22.39±4.63)min;期间CT扫描8~12次,平均(10.22±3.30)次。2例胃造瘘穿刺点周围发生轻度皮下血肿,未予特殊处理。术后24 h经胃管予流食,48 h予食糜。结论对欲行CT引导下经皮穿刺胃造瘘术而无法经口置入胃管进行胃腔充气者,可采用中心静脉导管套件辅助胃腔充气后实施操作。Objective To observe the feasibility of CT-guided percutaneous gastrostomy under central venous catheter assisted gastric lumen insufflation in patients being unable to intubate gastric lumen through the mouth.Methods Data of 26 patients with hypopharyngeal or esophageal cancer who underwent CT-guided percutaneous gastrostomy were retrospectively analyzed.All patients could not be insufflated by transoral cannulation into the gastric lumen,and then underwent CT-guided percutaneous gastrostomy after establishing percutaneous puncture insufflation access to the stomach under the assistance of a central venous catheter kits.The success rate and complications of this procedure were observed.Results CT-guided percutaneous gastrostomy under central venous catheter kit assisted gastric lumen inflation was performed successfully in all 26 patients.The operation time ranged from 15 to 45 min,with a mean of(22.39±4.63)min.During the operation,CT scanning was performed 8—12 times,with a mean of(10.22±3.30)times.Mild subcutaneous hematoma around the gastrostomy puncture site occurred in 2 cases but needed no special treatment.All patients were given liquid food via gastric tube within 24 h after operation and chyme within 48 h.Conclusion For patients being necessary to undergo CT-guided percutaneous gastrostomy but unable to intubate the gastric lumen through the mouth,it was feasible to perform this procedure after central venous catheter kits assisted gastric lumen inflation.

关 键 词：食管肿瘤 下咽肿瘤 中心静脉置管 肠内营养 体层摄影术 X线计算机 

分 类 号：R735[医药卫生—肿瘤] R815[医药卫生—临床医学]