Gabriel S A, McDaniel B, Ashley D W, Dalton M L, Gamblin T C
Department of Family Medicine, Mercer University School of Medicine, Medical Center of Central Georgia, Macon 31207, USA.
Am Surg. 2001 Jun;67(6):544-8; discussion 548-9.
Our objective was to evaluate a new technique for the bedside placement of nasoenteral feeding tubes into the duodenum using an external hand-held magnet to maneuver the tube from the stomach to the distal duodenum. We conducted a prospective case series of 20 consecutive patients requiring nasoenteral tube feeding in the intensive care units of a university-affiliated hospital. Twenty patients were entered into the study after the attending physician requested assistance in tube placement. A flexible nasoenteral feeding tube (12 F), modified to include a magnet and a magnetic field sensor in the distal tip connected by a thin insulated wire to a small light at the proximal end, was passed per nares into the stomach. A larger hand-held magnet held over the epigastrium was used to magnetically "capture" the tube tip, indicated by the illumination of the proximal light. The tube tip was then maneuvered by the hand-held magnet along the lesser curvature of the stomach, through the pylorus, and into the duodenum. Procedure time and anatomic location of the tube tip as determined by an abdominal radiograph was recorded. The 12 men and eight women had a mean age of 60 years (range 30-84). The procedure time averaged 9.6 minutes (range 1-30). In 19 of the 20 patients (95%) radiographs revealed successful placement of the tip of the feeding tube into the duodenum. There were no complications related to the procedure. Using a novel magnetically guided nasoenteral feeding tube transpyloric tube placement was achieved in 95 per cent of cases with an average procedure time of 9.6 minutes. This new and inexpensive bedside technique will allow prompt and safe initiation of enteral nutrition.
我们的目标是评估一种利用外部手持磁铁将鼻肠饲管在床旁放置到十二指肠的新技术，该技术通过磁铁将饲管从胃 maneuver 到十二指肠远端。我们在一所大学附属医院的重症监护病房对 20 例连续需要鼻肠管喂养的患者进行了前瞻性病例系列研究。在主治医生请求协助放置饲管后，20 例患者进入研究。一根柔性鼻肠饲管（12F），其远端尖端经过改良，包括一个磁铁和一个磁场传感器，通过一根细绝缘电线连接到近端的一个小灯，经鼻孔插入胃内。将一个较大的手持磁铁置于上腹部上方，用于通过磁性“捕获”饲管尖端，近端的灯亮起即表明已捕获。然后用手持磁铁将饲管尖端沿着胃的小弯、穿过幽门 maneuver 到十二指肠。记录操作时间以及通过腹部 X 光片确定的饲管尖端的解剖位置。12 名男性和 8 名女性的平均年龄为 60 岁（范围 30 - 84 岁）。操作时间平均为 9.6 分钟（范围 1 - 30 分钟）。在 20 例患者中的 19 例（95%），X光 片显示饲管尖端成功放置到十二指肠。该操作无相关并发症。使用一种新型的磁导向鼻肠饲管，95%的病例实现了经幽门放置饲管，平均操作时间为 9.6 分钟。这种新的且成本低廉的床旁技术将能够迅速且安全地开始肠内营养。
