超声造影引导鼻空肠管置放术

Contras-enhanced ultrasound-directed nose-intestinal feeding tube placement

目的探讨超声造影引导鼻空肠管置放术的可行性。方法24例拟行肠内营养支持的ICU住院患者作为研究对象，以Flocare螺旋型鼻空肠管经鼻带导丝置入胃腔，向管腔内注入造影剂SonoVue，实时超声监测下通过幽门，无强阻力下持续推送直至十二指肠-空肠段，腹部X线平片最终确认鼻空肠管位置后拔出导丝固定鼻空肠管行肠内营养支持治疗。结果超声造影引导鼻空肠管置放术24例，成功21例（87．5％），失败3例（12．50％），术中所有患者病情均无特殊变化。结论超声造影引导鼻空肠管置放术是一种操作简便快捷、安全可靠的置管技术，为危重症患者早期肠内营养支持提供了一条有效的途径。

Objective To investigate the feasibility of contrast-enhanced ultrasound-directed nose- jujunium tube placement. Methods Twenty four patients hospitalized in ICU who need support from enteral feeding were collected for this study. Flocare spiral nose-jejunium tube was placed into stomach with guide wire. Real-time ultrasound was used after injection of SonoVue for monitoring the passage of feeding tube from pylorus to duodenum jejunum segment which was pushed down if without strong resistant force. Finnally,the guide wire was drawed out and enteral feeding was conducted with ascertainment of abdominal X ray photograph for suitable site in intestinal tract. Results Contrast ultrasound -directed nose jejunum tube placement procedure was conducted in 24 cases. Twenty-one cases （87.5%） was accomplished successfully,and 3 cases （12.5%） was failed. No special change was observed in the procedure of all patients. Conclusions Contrast ultrasound-directed nose-jejunum tube placement procedure can be regarded as a convenient, safe, and reliable insertion technology, which provide an effective means for early enteral nutrition for critical patients.