Endoscope Assisted Nasogastric-Nasojejunal Tube Placement in Patient with Delayed Gastric Emptying: Report of a Case

內視鏡協助置放雙管腔之鼻胃／鼻腸管於胃排空延遲之病患：一病例報告

張維國(Wei-Kuo Chang) ； 施宇隆(Yu-Lueng Shih) ； 黃文豪(Wen-Hao Huang) ； 謝財源(Tsai-Yuan Hsieh) ； 徐榮源(Rong-Yaun Shyu) ； 趙有誠(You-Chen Chao)

《中華民國消化系醫學雜誌》 18卷2期 (2001/06) Pp. 145-150

https://doi.org/10.6557/GJTb.200106_18(2).0006

摘要

腸道營養可以預防腸道黏膜萎縮，並且改善病患營養狀況。胃排空延遲之病患，常有噁心、嘔吐、及胃排空異常，因此無法接受腸道正常餵食。針對消化性潰瘍併發胃排空延遲，重症病患可以接受內視鏡氣球擴張術、支架置放術、或手術治療；但是有較高之併發症及使死亡率。本文報告十二指腸潰瘍併發發排空延遲之患者，於加護病房床邊，接受內視鏡協助雙管腔之鼻胃／鼻腸管之置放。這種鼻胃／鼻腸管有兩個管腔，將鼻腸管腔置放於幽門括約肌之遠處，患者可以接受腸道餵食；將鼻胃管腔置於幽門括約肌之近端，就可以有效引流胃液、避免胃脹或吸入性肺炎之發生。接受這種鼻胃／鼻腸管之置放後；患者腹脹及營養狀況約明顯改善。這種內視鏡協助雙管腔之鼻胃／鼻腸管置放，為一簡單、有效、安全之技術；對病危之胃排空延遲之病患而言，是值得考慮使用之方法。

關鍵字

營養 ； 腸道灌食 ； 胃排空延遲

並列摘要

Peptic ulcer disease sometimes complicated by gastric outlet obstruction, hindering the passage of solids and liquids and leading to nausea, vomiting, and malnutrition. The treatment for peptic ulcer disease complicated with gastric outlet obstruction is either endoscopic balloon dilatation, stent implantation, or surgery, which may carry high morbidity and mortality in critically ill patients. This paper introduced a simple endoscope assisted feeding tube placement at bedside for a critically ill peptic ulcer patient with delayed gastric emptying. We used a double-lumen nasogastric/nasojejunal tube, which provides routes for nasogastric decompression with simultaneous nasojejunal feeding. Using this feeding tube, the patient could receive desired caloric intake via the nasojejunal feeding with minimizing the risk of aspiration. Moreover, the endoscope assisted nasogastric/nasojejunal tube placement is safe, simple, and easy to perform. It is an excellent alternative choice other than balloon dilatation, stent implantation, or surgery for critically ill patients with delayed gastric emptying.

並列關鍵字

nutrition ； enteral feeding ； delayed gastric emptying