Endoscopically Assisted Nasoduodenal Feeding Tube Placement for Early Enteral Feeding in Patients with Major Burn

內視鏡鼻十二指腸管置放術於重度燒傷病人之早期腸道餵食

黃俊彥(Chun-Yen Huang) ； 陳邦基(Pang-Chi Chen) ； 楊瑞永(Jui-Yung Yang) ； 董東瓚(Tung-Chain Tung)

《中華民國消化系醫學會雜誌》 9卷4期 (1992/12) Pp. 261-265

https://doi.org/10.6557/GJTa.199212_9(4).0001

摘要

最近的研究顯示早期經腸道餵食對重度燒傷病人可能有所助益。經鼻十二指腸餵食可以得到與經胃餵食相似之營養補給，但沒有腹脹，胃食道逆流或吸入性肺炎等併發症。然而要將餵食管放到十二指腸內常常很困難。從一九九一年六月至十一月間，我們使用一個簡單的方法，在內視鏡的指引下來放置一種腸道餵食管(Kangrao®)，在20例重度燒傷病人（平均燒傷面積63.8±19%）身上，成功地將管子放置到十二指腸遠端共二十三次。所有的病人均在住院後二十四小時內接受管子置放，整個過程在平均12.2±5.6分鐘完成，管子平均留置時間為17.3±11.3天。有2例意外地將管子拔除，有1例的管子在放置一天後滑出至胃，但3例均成功的以同法將管子放回去，沒有任何一例發生與管子置放有關的併發症或死亡。我們的結論是內視鏡輔助之鼻十二指腸管置放術是一安全、方便而且有效的方法，可適切地提供重度燒傷病人之早期經陽道餵食。

關鍵字

鼻十二指腸管 ； 內視鏡 ； 燒傷

並列摘要

Recent studies have indicated that early enteral feeding may be beneficial in patients with major burns. Nasoduodenal feedings can achieve nutritional support similar to gastric feedings and without the complications of gastric distension, gastroesophageal reflux, or aspiration; however, placement of a feeding tube into the distal duodenum is often a difficult task. From June to November 1991, we used a simple method to place an enteral feeding tube (Kangaroo®, Sherwood Medical, St. Louis) under direct endoscopic guidance. We successfully placed the tube into the distal duodenum 23 times in 20 patients (mean age 41.1±13.8 year) with major burns (mean burn size 63.8±19%). All the patients received the procedure within 24 hours after admission. The procedure was completed within a mean time of 12.2±5.6 minutes. The tube was left in place for 17.3±11.3 days. Two patients withdrew their tubes accidentally, and 1 patient's tube slipped back into the stomach a day later, but all 3 were placed back again successfully. There were no procedure-related complications or mortality. We conclude that endoscopically assisted nasoduodenal tube placement is a safe, convenient, and effective method for early enteral feeding in patients with major burns.

並列關鍵字

nasoduodenal feeding tube ； endoscopy ； burn