Barinagarrementeria R, Blancas Valencia J M, Teramoto Matsubara O, de la Garza González S
Servicio de Endoscopia, Hospital de Especialidades, México, D.F.
G E N. 1991 Apr-Jun;45(2):98-100.
We studied 30 patients. 20 were males and 10 females. Mean age was 48 year old. Esophageal disease was not present neither gastro-esophageal reflux. Biopsy was taken between 24 hours and 25 days after nasogastric tube (NG) was put into place. Endoscopic findings were: hyperemic mucosa, submucosal hemorrhage, clots, erosions and ulcers near Esophago-gastric junction. Intraepithelial edema, vessel congestion, polymorphonuclear infiltration, fibrin thrombosis of submucosal vessels, ischemia, epithelial regeneration and ulcer were common histologic findings. All endoscopic and histologic alterations were related to the length of time of NG tube contact with the esophageal mucosa. We concluded that NG tube damages the esophageal mucosa by two mechanisms: a) Local irritation that favors b) gastric reflux by decreasing lower esophageal sphincter pressure.
我们研究了30名患者。其中20名男性,10名女性。平均年龄为48岁。不存在食管疾病,也没有胃食管反流。在插入鼻胃管(NG)后的24小时至25天之间进行活检。内镜检查结果为:食管胃交界处附近黏膜充血、黏膜下出血、血凝块、糜烂和溃疡。上皮内水肿、血管充血、多形核浸润、黏膜下血管纤维蛋白血栓形成、缺血、上皮再生和溃疡是常见的组织学表现。所有内镜和组织学改变均与鼻胃管与食管黏膜接触的时间长短有关。我们得出结论,鼻胃管通过两种机制损害食管黏膜:a)局部刺激,这有利于b)通过降低食管下括约肌压力导致胃反流。