鼻胆管在三腔营养管置管困难肠内营养患者中的应用

Application of nasobiliary drainage tube in enteral nutrition patients with difficulty placing three-lumen nutritional tube

关键词:  鼻胆管  肠内营养  胃镜  X线

Key words:  nasobiliary drainage tube  enteral nutrition  gastroscopy  X-ray

摘要:

目的 探讨胃镜联合X线下使用Seldinger技术置入鼻胆管行肠内营养支持治疗在三腔营养管置管困难患者中的可行性。方法 对28例常规胃镜下置入三腔营养管困难的患者，在胃镜联合X线下操作置入鼻胆管，通过鼻胆管输注肠内营养液。观察置管操作时间、一次置管成功率、脱管率、患者的耐受性和并发症发生率等。结果 置管操作时间5~15 min，一次置管成功率达100%，脱管率为0，患者耐受性好，术中及术后无并发症发生。结论 在胃镜联合X线下操作置入鼻胆管进行空肠营养的方法，具有很高的安全性和可行性，尤其对解剖结构变异、吻合口或肠段狭窄等胃镜下常规置入三腔营养管困难的患者。

Abstract:

Objective To explore the feasibility of gastroscope combined with X-ray using Seldinger technique to insert nasobiliary tube for enteral nutrition support in patients with difficulty placing three-lumen nutritional tube. Methods For 28 patients who required enteral nutrition and had difficulty inserting a three-lumen nutritional tube, nasobiliary tube was placed under gastroscope combined with X-ray, and enteral nutrition solution was infused through the nasobiliary tube. The operation time of tube placement, success rate of one-time tube placement, rate of tube removal, tolerance of indwelling tube, and incidence of complications were observed. Results The operation time of tube placement was 5-15 minutes, the success rate of one-time tube placement was 100%, and the rate of tube removal was 0. The procedure was well tolerated, and no complications occurred during or after surgery. Conclusion The procedure of inserting nasobiliary tube for jejunal nutrition under gastroscope combined with X-ray has high safety and feasibility, especially for patients with anatomical structure variation, anastomosis or intestinal stenosis and difficulty placing three-lumen nutrition tube.