改良法经鼻置胃管的应用解剖学研究

The Applied Anatomic Study of Inserting the Gastric Tube through the Nasal Passage by the Improved Methods

目的:为临床提供改良法经鼻置胃管的应用解剖学信息。方法:选取30例无畸形和外伤的尸体标本,分别在传统法和改良法两种不同姿势下经鼻置胃管,对放置胃管穿经的鼻腔、咽、食管进行解剖和测量,传统法经鼻置胃管测量设为对照组,改良法经鼻置胃管测量设为试验组。结果:对照组舌骨后缘至咽后壁距离(28.34±1.22)mm,试验组舌骨后缘至咽后壁距离(25.65±0.98)mm,两组比较差异有统计学意义(P<0.05);对照组颅底至舌骨后缘距离(78.47±1.73)mm,试验组颅底至舌骨后缘距离(74.28±1.42)mm,两组比较差异有统计学意义(P<0.05);对照组鼻腔-咽-食管的角度为(94.00±1.02)°,试验组鼻腔-咽-食管的角度为(125.00±2.54)°,两组比较差异有统计学意义(P<0.05)。结论:改良法置胃管能减小插管路径的曲度,减轻置管时对咽壁的刺激,降低咽反射强度,利于胃管的置入。

Objective：To provide applied anatomy information for clinical work about inserting the gastric tube through the nasal passage by the improved methods.Method：A total of 30 cases of specimens without deformity or trauma were chosen.They were inserted the gastric tube by two different methods.One was the traditional method,and the other was the improved method.Objects of anatomy and measurement were the nasal cavity,pharynx and esophagus.The control group was given traditional method,and experimental group was given improved method.Result：The distance of posterior edge in the hyoid bone to posterior wall of pharynx was（28.34±1.22）mm in control group,and the distance of posterior edge in the hyoid bone to posterior wall of pharynx was（25.65±0.98）mm in experimental group,the difference was statistically significant（P0.05）;the distance base of the skull to the posterior edge of the hyoid bone was（78.47±1.73）mm in control group,and the distance of the base of the skull to the posterior edge of the hyoid bone was（74.28±1.42）mm in experimental group,the difference was statistically significant（P0.05）;the angle of the nasal cavity-pharynx-esophagus was（94.00±1.02）° in the control group,and the angle of the nasal cavity-pharynx-esophagus was（125.00±2.54）°in the experimental group,the difference was statistically significant（P0.05）.Conclusion：The improved method can reduce the curvature of the intubation path of the gastric tube,the stimulus of the pharynx wall when inserting gastric tube,and the intensity of pharyngeal reflex.So the improved method is conducive to insert the gastric tube.