内镜置入鼻空肠营养管两种技术的比较

A comparative study on endoscopic placement methods of nasal jejunum nutrition tube

目的比较鼻空肠营养管的鼻胃镜导丝引导置入技术与内镜下推送式置入技术的临床应用效果。方法2011年6月，选择因胃窦、幽门、十二指肠病变导致狭窄梗阻需要空肠营养治疗的40例患者，分成两组，进行鼻空肠营养管的内镜下常规推送式置入（推送组）与鼻胃镜导丝引导置入（导丝组），比较操作时间、置入一次性成功以及空肠营养管脱回胃内的情况。结果每组20例患者，均完成内镜鼻空肠营养管置入治疗。推送组与导丝组，操作平均时间分别是（750．3±445．9）S、（157．4±79．3）s，一次性成功率为85％、100％，空肠营养管脱回胃内发生率为30％、0％。两者比较，在操作平均时间上，差异具有非常显著性意义（P〈O．01）。结论置入鼻空肠营养管，鼻胃镜导丝引导置入技术比内镜下推送式置入技术，更具方便、操作简单的优点。

Objective To compare the clinical application effect of placing nasal jejunum nutrition tube by gastroscope and transnasal gastroscope. Methods In Jun 2011, the patients who need nasal jeju- num nutrition tube due to obstruction of gastric antrum, pylorus and duodenum were assigned randomly into gastroscope pushing group （GP） and transnasal gastroscope guide wire group （TNGGW）. Operation time, achievement ratio, and tube displacement ratio were compared. Results Nasal jejunum nutrition tubes were successfully placed in all patients by two methods. In GP group, the success rate was 85%, and mean time cost was （750. 3 ± 445.9） s, and tube displacement ratio was 30%. In TNGGW group, the success rate wasl00%, and mean time cost was （ 157.4 ± 79. 3）s with no tube displacement ratio. There was a statisti- cally significant difference in mean time cost between GP group and TNGGW group （ P 〈 0. 01 ）. Conclusion It is a more reliable and convenient method to place nasal jejunum nutrition tube by transnasal gastroscope than by gastroseope.