超细鼻胃镜辅助胃造瘘

Application of ultrathin transnasal gastroscopy in percutaneous endoscopic gastrostomy

目的探讨超细鼻胃镜在经鼻经皮内镜下胃造瘘术(nPEG)中的应用。方法采用Introducer法,对9例连续住院需胃造瘘病人分别用普通胃镜和超细鼻胃镜经皮内镜下胃造瘘。4例nPEG患者中,3例为鼻咽癌放疗术后患者,其中2例张口困难,1例张口困难伴咽喉部狭窄。分别比较两种方法操作的时间、安全性和并发症及舒适性,并观察超细鼻胃镜在张口困难或咽喉部狭窄患者中的应用情况。结果在本组的9例病人中,5例用普通胃镜进行了胃造瘘,4例用超细鼻胃镜胃造瘘,都取得了成功。普通内镜胃造瘘的时间平均为(17±3.5)min,而nPEG组的时间平均为(17±3.1)min。两种方法均无并发症,但nPEG组患者舒适性更好。结论超细鼻胃镜辅助胃造瘘更舒适安全的胃造瘘方法,特别适应于各种原因致张口困难和/或咽喉部狭窄的患者。

Objective To assess the application of ultrathin transnasal gastroscopy in transnasal percutaneous endoscopic gastrostomy （nPEG） in patients with trimus and/or pharyngeal narrowing. Methods Nine consecutive patients underwent PEG with the Introducer method using conventional gastroscopy （5 cases） or ultrathin transnasal gastroscopy （4 cases）. Among the 4 patients undergoing nPEG, 3 received radiotherapy for nasopharyngeal cancer, including two with trimus and one with trimus and pharyngeal narrowing. The procedure time, safety, discomfort and complications in these cases were compared and evaluated. Results The average procedure time of PEG was 17±3.5 min in conventional gastroscopy group and 17±3.1 min in nPEG group. No complications were observed in these patients, but the patients in nPEG group reported less discomfort associated with the procedure. Conclusions Ultrathin transnasal gastroscopy reduces the discomfort of the procedure and is safer than conventional gastroscopy for PEG, especially in patients with trimus and/or pharyngeal narrowing.