Passage of nasogastric tube through tracheo-esophageal fistula into stomach: A rare event

Esophageal atresia with tracheo-oesophageal fistula(TEF) occurs in 1 in 3500 live births. Anorectal malformation is found to be associated with 14% of TEF. Esophageal atresia with TEF is a congenital anomaly which classically presents as excessive frothing from the mouth and respiratory distress. Rarely gastric position of the feeding tube in a case of TEF can be obtained delaying the diagnosis of TEF. We had an uncommon situation where a nasogastric tube reached the stomach through the trachea and tracheo-esophageal fistula, leading to misdiagnosis in a case of esophageal atresia with tracheoesophageal fistula. By using a stiff rubber catheter instead of a soft feeding tube for the diagnosis of esophageal atresia and TEF, such situation can be avoided.

Routine nasogastric tube placement in patients with small esophageal perforation after endoscopic foreign body removal may be unnecessary:a propensity score matching analysis

Background:Nasogastric tube(NGT)placement is part of the post-operative management of upper gastrointestinal perforation,but its routine use in esophageal perforation(EP)caused by foreign bodies remains unclear.The purpose of this research was to investigate the necessity for routine NGT placement in patients with EP after endoscopic foreign body removal.Methods:A total of 323 patients diagnosed with EP caused by foreign bodies at the First Affiliated Hospital of Nanchang University between January 2012 and December 2021 were included in this retrospective study.Patients were divided into the NGT group and the non-NGT group according to whether or not NGT placement was performed.The perforation healing rate,post-operative adverse events,hospital stay,and death rate were analysed using a 1:1 propensity score matching model.Results:Before matching,there were 263 patients in the NGT group and 60 patients in the non-NGT group.There were significant differences in the time to treatment,infection,albumin,and types of endoscopy between the two groups,while the length of hospital stay in the NGT group was significantly longer than that in the non-NGT group.After 1:1 propensity score matching,48 pairs of patients were matched between the two groups.The perforation healing rate,post-operative adverse events,length of hospital stay,and death rate did not show significant differences between the two groups.Conclusions:For patients with small EP caused by foreign bodies,routine NGT placement after endoscopic foreign body removal may be unnecessary.

探讨不同鼻肠管置管方法在危重症患者中的应用及效果观察

目的:探讨鼻肠管置管的最佳方法及其效果观察。方法:将70例需留置鼻肠管行肠内营养的危重症患者分为两组,对照组35例采用传统方法置入胃内悬空漂浮至空肠内,实验组35例采用床旁盲插法主动置入空肠内。结果:实验组在成功率、置管到达空肠所需时间、并发症发生及胃动力要求方面明显优于对照组,有显著性差异(P<0.05)。结论:采用主动置入鼻肠管效果较好。

食管电极联合食管电图用于鼻胃管置入

目的观察食管电极引导鼻胃管置入的有效性及安全性。方法将94例接受鼻胃管置入患者按随机数字表法分为观察组(49例)及对照组(45例)。对照组采用传统方法置管和判断胃管置入位置;观察组在食管电极引导下进行鼻胃管置入,并以食管电图判断胃管置入位置。结果观察组操作时间、操作次数、一次置管成功率与对照组比较,差异有统计学意义(P<0.05,P<0.01);两组并发症发生率比较,差异无统计学意义(P>0.05)。4例未描记出食管电图的患者胃管置入位置有误。结论食管电极引导鼻胃管置入简便、易行,描记食管电图能准确反映胃管置入位置是否正确。

严重狭窄型食管癌鼻胃管置入方法的探讨

目的:探讨导管辅助鼻胃管置入方法在严重狭窄型食管癌的应用。材料与方法:不愿支架植入或急需营养支持的严重狭窄型食管癌患者15例,采用5F单弯管外套胃管,经鼻导丝引导通过食管狭窄段送入胃内。结果:导管辅助鼻胃管置入成功率100%,无严重并发症。结论:严重狭窄型食管癌导管辅助胃管置入方法成功率高,有效改善患者生存质量。

循证护理在ICU脑卒中患者床旁盲插螺旋形鼻肠管中的应用

目的研究循证护理在ICU脑卒中患者床旁盲插螺旋形鼻肠管中的应用效果。方法选取2016年9月至2017年9月于我院ICU收治的脑卒中患者140例作为分析对象,随机分为两组,两组均采用床旁盲插螺旋形鼻肠管技术,对照组运用常规护理方法进行护理,观察组运用循证护理干预,比较两组一次置管成功率、意外脱管发生率,反流呃逆、呕吐误吸发生率及患者满意度。结果观察组患者的一次置管成功率高于对照组,意外脱管发生率低于对照组,且反流呃逆、呕吐误吸发生率明显低于对照组,患者满意度高于对照组(P均<0.05)。结论对ICU脑卒中患者实施床旁盲插螺旋形鼻肠管技术合并循证护理干预,临床效果显著,提高了一次置管发生率,降低了意外脱管发生率、降低了反流呃逆、呕吐误吸发生率,提高患者的满意度及生活质量。