Hung C-W, Lee W-H
Department of Emergency Medicine, Chang Gung Memorial Hospital, 123, Dabi Road, Niausung Shiang, Kaohsiung, 833, Taiwan, ROC.
Emerg Med J. 2008 Jan;25(1):23-5. doi: 10.1136/emj.2007.049312.
It can sometimes be difficult to insert a nasogastric tube (NGT) in a patient in whom intubation has been performed. Because of the patient's inability to swallow and the presence of the inflated cuff of the endotracheal tube, the NGT will often become coiled in the oral cavity. A previous study showed that rigid tubes require fewer insertion attempts than flexible tubes. An attempt was therefore made to increase the rigidity of NGTs by filling the tube with water (water-fill method). The objective of this study was to investigate whether water-filled NGTs would facilitate tube insertion.
Sixty-six patients intubated with rapid sequence induction in the emergency department were consecutively recruited over a study period of 4 months in 2006. In the first 2 months the patients underwent NGT insertion by the water-fill method (water-fill group) and in the subsequent 2 months NGT insertion was undertaken by the traditional method (control group). Successful NGT insertion for each patient was defined as the passage of the tube in <or=2 attempts. The rate of successful insertion was compared between the two groups.
Successful insertions were achieved in 29/31 patients (93.5%) in the water-fill group and in 23/35 patients (65.7%) in the control group. The difference between the two groups was statistically significant (p<0.01).
The water-fill method is a simple and fast method to facilitate NGT insertion in intubated patients.
对于已进行气管插管的患者，有时插入鼻胃管（NGT）会很困难。由于患者无法吞咽且气管插管的气囊充气，NGT常常会在口腔内盘绕。先前的一项研究表明，刚性管比柔性管所需的插入尝试次数更少。因此，尝试通过向管内注水（注水法）来增加NGT的刚性。本研究的目的是调查注水的NGT是否有助于插管。
2006年，在4个月的研究期间，连续招募了66例在急诊科接受快速顺序诱导插管的患者。在前2个月，患者采用注水法进行NGT插入（注水组），在随后的2个月，采用传统方法进行NGT插入（对照组）。每位患者成功插入NGT定义为在≤2次尝试内完成插管。比较两组的成功插入率。
注水组31例患者中有29例（93.5%）成功插入，对照组35例患者中有23例（65.7%）成功插入。两组之间的差异具有统计学意义（p<0.01）。
注水法是一种简单快速的方法，有助于在插管患者中插入NGT。
