- 期刊
An Improved Method of Nasojejunal Feeding Tube Placement for Patients Requiring Endoscopic Nasobiliary Drainage
鼻胆管引流患者放置空肠营养管的一种新方法
摘要
目的：为避免鼻胆管引流患者放置空肠营养管时二次内镜检查的痛苦，我们研究改进了新的置管方法，并与原有的内镜下空肠营养管置入术的方法进行比较。方法：将需要放置鼻胆管引流的病人分为两组，一组用内镜下空肠营养管置入术18例，另一组用我们研究改进的新方法放置空肠营养管26例。记录空肠营养管置入的时间、病人的生理状况及并发症等。结果：内镜下空肠营养管置入术18例，有14例一次置管成功，成功率为77.8%，有1例误入气管病人呛咳，拔出后二次置管成功，总成功率为83.3%，平均置管时间为17分钟。用我们研究改进的新方法放置空肠营养管26例，均一次置管成功，成功率为100%，平均置管时间为2.55分钟。对于鼻胆管引流的患者来说，改进的新方法放置空肠营养管成功率明显高于内镜下空肠营养管置入术（χ^2=36.4，p＜0.05），操作时间也明显短于后者（t=18.5，p＜0.05）。结论：对需要放置鼻胆管引流的病人，我们研究的新方法比内镜下空肠营养管置入术更方便、有效、快速、便宜，而且避免了二次内镜检查的痛苦，并发症少，安全性及成功率高。该方法对鼻胆管引流患者是一种安全、有效、实用性强的肠内营养置管方法，值得在临床工作中广泛推广。
並列摘要
Objective: To avoid a second endoscopy for nasojejunal feeding tube placement (NFTP) in patients undergoing endoscopic nasobiliary drainage (ENBD), we studied improved NFTP method and compared it to endoscopic method. Methods: Patients with ENBD were divided into two groups. One group (18 patients) received endoscopic NFTP and the other group (26 patients) received improved NFTP. Placement time, physical condition of the patients and complications were recorded. Results: In 18 patients who underwent endoscopic NFTP, NFT was successfully placed on the first attempt in 14 patients with a first placement success rate of 77.8%. NFT was wrongly intubated into the trachea in one patient inducing coughing, and after it was removed, the second placement was successful. The total success rate of endoscopic NFTP was 83.3% with an average placement time of 17.0 minutes. In 26 patients undergoing improved NFTP, all were successfully placed on the first attempt with a success rate of 100%, and an average placement time of 2.55 minutes. In patients with ENBD, the success rate of improved NFTP was significantly higher than endoscopic NFTP (χ^2=36.4, p＜0.05) with a significantly shorter placement time (t=18.5, p＜0.05). Conclusion: For patients with ENBD, improved NFTP method is superior to the endoscopic method as it is more effective, convenient, faster, and cheaper. Additionally it avoids a second endoscopy and has fewer complications, better security and a higher success rate. The improved method is a safer, easier, more effective and practical method of EN and deserves general adoption in clinical work.
延伸閱讀
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