电子胃镜下斑马导丝转换技术用于空肠营养管置入术的安全性及有效性研究

Study on the safety and effectiveness of zebra guide wire conversion technique in jejunal nutrition tube implantation under electronic gastroscope

摘要:

目的 探讨标准型胃镜下斑马导丝转换技术用于空肠营养管置入术的安全性及有效性。方法 选取承德市中心医院2017年1月－2021年12月胃镜下放置螺旋型鼻肠管的患者80例，随机分为实验组与对照组，各40例。实验组使用标准型胃镜将斑马导丝置入十二指肠远端后，保持导丝位置相对固定，退出内镜，应用一次性导尿管将斑马导丝置换至鼻腔的方法代替经鼻胃镜下置入导丝技术；对照组使用标准型胃镜下钳夹推送置入螺旋型鼻肠管技术。结果 实验组较对照组操作时间短，两组患者比较，差异有统计学意义（P < 0.05）；实验组鼻咽部不适及腹痛腹胀发生率明显低于对照组，两组患者比较，差异有统计学意义（P < 0.05）；两组患者一次性置管成功率、误吸及导丝移位发生率比较，差异均无统计学意义（P > 0.05）。结论 采用斑马导丝转换技术将斑马导丝置换至鼻腔的方法与传统内镜钳夹法相比，具有操作简单和并发症少等优势，且安全有效，可为广大基层医院提供技术支持，从而为消化内镜营养管置入术提供新思路。

Abstract:

Objective To investigate the safety and effectiveness of zebra guide wire conversion technique for jejunal nutrition tube implantation under standard gastroscope.Methods 80 patients with spiral nasointestinal tube placed under gastroscope from January 2017 to December 2021 were selected and randomly divided into experimental group and control group, 40 patients in each group. The experimental group used standard gastroscope to place zebra guide wire into the distal duodenum, keep the guide wire position relatively fixed, and replace zebra guide wire into the nasal cavity with disposable catheter after exiting the endoscope instead of inserting guide wire under nasal endoscopy. In the control group, spiral nasointestinal tube was inserted by forceps under standard gastroscope.Results The experimental group under the standard gastroscope was shorter than that of the control group, and there was a statistically significant difference in the operation time between the two groups (P < 0.05); The incidence of nasopharynx discomfort, abdominal pain and abdominal distension in the experimental group was significantly lower than that in the control group, the difference between the two groups was statistically significant (P < 0.05); There were no significant difference in the success rate of one-time catheterization, incidence of aspiration and guide wire displacement (P > 0.05).Conclusion The method of replacing zebra guide wire to nasal cavity with zebra guide wire conversion technology instead of traditional endoscopic clamping method has the advantages of simple operation and few complications, and is safe and effective, which provides technical support for the majority of grass-roots hospitals, and thus provides a new idea for the placement of nutrient tube in digestive endoscopy.