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鼻胃管症候群是罕見的問題,對於使用鼻胃管灌食的病患來說,爲一有潛在性威脅生命的併發症。目前認爲原因是由於鼻胃管長期置放導致後環狀肌區的軟組織潰瘍以及感染,腫大後造成聲帶外展的功能障礙,進而完全喪失聲帶外展功能,引發嚴重的氣道阻塞及呼吸障礙。目前文獻上之病例仍屬相當有限。 本病例報告描述一位長期使用鼻胃管之案例,此位64歲女性病患因敗血性休克併多重器官衰竭而入院。在考量意識狀態不清的狀況下,爲了避免吸入性肺炎的產生及營養的供應而置放鼻胃管。當病患病況穩定後試圖拔除氣切管,但期間屢屢失敗。之後進行一系列之檢查,包括了纖維鏡檢查、泛上消化道內視鏡檢查、頭頸部核磁共振掃描檢查、以及支氣管鏡檢查,皆發現位於在咽喉部的腫塊。最後進行生檢後確定為發炎腫塊,判斷可能的原因為長期使用鼻胃管而引發之鼻胃管症候群。在經過經皮內視鏡胃造廔後,拔除鼻胃管,併發症因此而緩解。 本報告呈現此病例之臨床療程,並回顧相關文獻,探討鼻胃管症候群之臨床表現和併發症,以供臨床醫師參考。

Parallel abstracts

The nasogastric tube syndrome (NG tube syndrome) is a rare but a potentially life-threatening complication of a patient with indwelling nasogastric tube feeding. The cause of the syndrome is due to the NG tube irritation, resulting in ulceration and infection of the posterior cricoid region with subsequent dysfunction of vocal cord abduction. This dysfunction may result in complete loss of vocal cord abduction and cause serious airway obstruction. Reports of this syndrome are rare in the literature. A 64-year-old female patient with long-term NG tube feeding, suffered from serious upper airway obstruction. The patient had obvious desaturation while the tracheostomy tube was corked, and the endoscopic findings showed severe upper airway swelling. The symptoms associated with NG tube syndrome improved gradually after the NG tube removal pollowing a percutaneous endoscopic gastrostomy (PEG). We present the clinical course of the case with NG tube syndrome and provide a comprehensive review of this topic.