Weinberg L, Skewes D
Department ofAnaesthesia, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia.
Anaesth Intensive Care. 2006 Apr;34(2):276-9. doi: 10.1177/0310057X0603400202.
Nasogastric tube insertion is a commonly performed procedure that can be associated with significant morbidity and even mortality. There is no universally accepted technique to confirm correct placement. Most confirmatory methods are performed after placement, therefore misplacement and potential complications may have already occurred. We report a case where a commonly used bedside confirmatory test gave false reassurance that the nasogastric tube was properly positioned, but a plain chest X-ray revealed a massive pneumothorax due to inadvertent intrapleural placement of the tube. Due to the deficiencies of traditional confirmatory bedside techniques, and the limitations of modern and more sophisticated confirmatory methods, the plain chest X-ray remains the gold standard test to confirm correct nasogastric tube placement. We appraise the methods commonly employed to confirm nasogastric tube placement, and discuss factors that may increase the risk of misplacement.
鼻胃管插入是一种常见的操作，但可能会导致严重的发病甚至死亡。目前尚无普遍接受的确认正确放置的技术。大多数确认方法是在放置后进行的，因此可能已经发生了误置和潜在并发症。我们报告了一例病例，一种常用的床边确认试验错误地让人放心鼻胃管放置正确，但胸部X线平片显示因鼻胃管意外置入胸膜腔而导致大量气胸。由于传统床边确认技术的不足，以及现代更复杂确认方法的局限性，胸部X线平片仍然是确认鼻胃管正确放置的金标准检查。我们评估了常用于确认鼻胃管放置的方法，并讨论了可能增加误置风险的因素。
