Department of Gastroenterology, Peking University Third Hospital, Beijing, China.
J Dig Dis. 2012 Jun;13(6):310-5. doi: 10.1111/j.1751-2980.2012.00594.x.
To evaluate the feasibility and efficacy of small-caliber transnasal esophagogastroduodenoscopy for the placement of nasoenteric feeding tubes (NET) in patients with severe upper gastrointestinal (GI) diseases.
Between January 2007 and March 2010, 51 patients underwent transnasal endoscopy for the placement of NET in Peking University Third Hospital. Indications for NET included esophageal stricture or gastric outlet obstruction because of corrosive esophagitis or gastritis, partial obstruction due to malignancy, stenosis in stoma or efferent loop, gastroparesis, metallic stent in upper GI tract, tracheoesophageal fistula, severe acute pancreatitis, anorexia nervosa and intensive care patients. The tubes were endoscopically placed using the guidewire technique. The position of the tube was confirmed by the immediate second endoscopy or abdominal X-ray. If the initiate placement was not correct, an adjustment or a second placement was conducted immediately.
Initial post-pyloric placement of NET was achieved in 43 of 51 patients (84.3%), but the total success rate reached 98.0% (50/51) after the second placement. The time required for the procedure ranged from 10 to 35 min, with a median time of 20.4 min. Epistaxis occurred in 2 patients. There were no complications of hemorrhage, perforation or aspiration.
The transnasal endoscopic placement of NET was feasible in patients with upper GI diseases, especially in those with changed anatomy.
评估经小口径鼻腔内胃镜在上消化道（GI）严重疾病患者中放置鼻胃管（NET）的可行性和疗效。
2007 年 1 月至 2010 年 3 月，51 例患者在北京大学第三医院行经鼻内镜放置 NET。NET 的适应证包括腐蚀性食管炎或胃炎所致食管狭窄或胃出口梗阻、恶性肿瘤部分梗阻、吻合口或输出袢狭窄、胃轻瘫、上消化道金属支架、气管食管瘘、重症胰腺炎、神经性厌食和重症监护患者。使用导丝技术将导管插入内镜。通过即刻进行的第二次内镜或腹部 X 线检查确认导管位置。如果初始放置不正确，则立即进行调整或再次放置。
43 例（84.3%）患者首次成功将 NET 置于幽门后，但在进行第二次放置后，总成功率达到 98.0%（50/51）。手术时间为 10 至 35 分钟，中位数为 20.4 分钟。2 例患者出现鼻出血。无出血、穿孔或吸入等并发症。
经鼻腔内镜放置 NET 在上消化道疾病患者中是可行的，尤其是在解剖结构改变的患者中。
