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超声引导下重症急性胰腺炎患者肠内营养管置入:一种提高质量的新方法。

Enteral nutrition tube placement assisted by ultrasonography in patients with severe acute pancreatitis: A novel method for quality improvement.

作者信息

Li Gang, Pan Yiyuan, Zhou Jing, Tong Zhihui, Ke Lu, Li Weiqin

机构信息

Surgery Intensive Care Unit, Department of General Surgery, Jinling Hospital, Nanjing, Jiangsu Province, China.

出版信息

Medicine (Baltimore). 2017 Nov;96(45):e8482. doi: 10.1097/MD.0000000000008482.

Abstract

To evaluate the effect of a novel procedure using real-time ultrasonography to assist nasojejunal tube placement at bedside in patients with severe acute pancreatitis (SAP).Single center, prospective descriptive study in a 15-bed surgery intensive care unit of a university hospital. Thirty SAP patients were enrolled. The whole procedure of placing nasojejunal tube was performed by a single physician, who places nasojejunal tube at the bedside and performs ultrasonography to guide the tube positioning. The final nasojejunal tube position was confirmed by abdominal radiograph. The successful rate of the procedure as well as the time it took, the time from the decision of enteral feeding to commencement of feeding, and complications were recorded.Thirty-six intubations were performed in 30 patients by using ultrasonography-assisted method at bedside. Nasojejunal tubes were successful placed in 28 of 30 patients (93.3%). The average time of successful placement was 22.07 ± 5.78 minutes. The median time between physician's decision for tube placement and feeding initiation was 5.5 (2, 24) hours. No adverse events occurred in all of patients.This novel method of nasojejunal tube placement under ultrasound guidance is practical, less time consuming and reliable.

摘要

评估一种使用实时超声引导在重症急性胰腺炎(SAP)患者床边放置鼻空肠管的新方法的效果。在一所大学医院拥有15张床位的外科重症监护病房进行单中心前瞻性描述性研究。纳入30例SAP患者。鼻空肠管放置的整个过程由一名医生完成,该医生在床边放置鼻空肠管并进行超声检查以引导管道定位。最终鼻空肠管位置通过腹部X线片确认。记录该操作的成功率、所需时间、从决定肠内营养到开始喂养的时间以及并发症。通过超声辅助方法在30例患者中进行了36次插管。30例患者中有28例(93.3%)成功放置鼻空肠管。成功放置的平均时间为22.07±5.78分钟。医生决定放置管道到开始喂养的中位时间为5.5(2,24)小时。所有患者均未发生不良事件。这种在超声引导下放置鼻空肠管的新方法实用、耗时少且可靠。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a69/5690728/412e4ad8b8a9/medi-96-e8482-g001.jpg

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