Department of Critical Care Medicine, Second People's Hospital of Shenzhen, Shenzhen, 518035, People's Republic of China.
Department of Neurosurgery, Longgang Central Hospital of Shenzhen, Shenzhen, 518116, People's Republic of China.
Biomed Eng Online. 2018 Feb 7;17(1):21. doi: 10.1186/s12938-018-0452-1.
At present, the enteral nutrition approaches via nose and duodenum (or nose and jejunum) are the preferred method of nutritional support in the medical engineering field, given the superiority of in line with physiological processes and no serious complication. In this study, the authors adopted saline as the acoustic window, and gave enteral nutrition support to critically ill patients, via the nasogastrojejunal approach guided by semi-automated ultrasound. These above patients benefited a lot from this kind of nutrition support treatment, and we aimed to report the detailed information.
Critically ill patients (n = 41) who had been treated with hospitalized intestine nutrition were identified. The Apogee 1200 ultrasonic diagnostic apparatus, and nasogastrojejunal tubes were adopted to carry out intestine nutrition treatment guided by semi-automated ultrasound. In order to confirm the specific positions of cardia, gastric body, antrum of stomach, and pylorus, the semi-automated ultrasound was utilized to probe the stomach cavity. And then, the ultrasonic probe was placed in the cardia location, and the nasogastrojejunal tube was slowly inserted through the metal thread. After operation, the nursing service satisfaction of patients and mean operation time were calculated, respectively.
All the patients were treated with enteral nutrition via nasogastrojejunal tube, and the whole procedure was under the guidance of semi-automated ultrasonography. The end of the feeding tube is attached to the surface of the stomach with a greater curvature, which can be bent on account of a no gastric peristalsis squeeze function, and thereby were prevented from entering into the antrum and pylorus locations. After this procedure, the mental thread was taken out, and the tube was pushed forward by a "drift" approach in order to allow it to enter into the intestine. The total nursing service satisfaction of patients was 90.24%, and the total incidence of adverse reactions was 17.07%.
In summary, the application of saline can be taken as sound window, and the metal wire as the tracking target, the bedside nasogastrojejunal tube guided by semi-automated ultrasound is an effective feeding tube placement method, with relatively good clinical application value in medical engineering.
目前,医学工程领域首选的肠内营养途径是经鼻-十二指肠(或鼻-空肠),因为这种方法符合生理过程,且无严重并发症。在本研究中,作者采用生理盐水作为声窗,采用半自动化超声引导经鼻胃空肠营养支持,为危重症患者进行肠内营养支持。上述患者从这种营养支持治疗中获益良多,我们旨在报告详细信息。
确定接受住院肠内营养治疗的危重症患者。采用 Apogee 1200 超声诊断仪和鼻胃空肠管,采用半自动化超声引导进行肠内营养治疗。为了确定贲门、胃体、胃窦和幽门的具体位置,利用半自动化超声探查胃腔。然后,将超声探头放置在贲门位置,将鼻胃空肠管通过金属丝缓慢插入。术后计算患者的护理服务满意度和平均操作时间。
所有患者均采用经鼻胃空肠管进行肠内营养治疗,整个过程均在半自动化超声引导下进行。喂养管的末端附着在胃大弯的表面,可以弯曲,因为没有胃蠕动挤压功能,从而防止进入胃窦和幽门部位。操作完成后,取出金属丝,通过“漂移”的方式推动管子,使其进入肠道。患者的总护理服务满意度为 90.24%,不良反应总发生率为 17.07%。
综上所述,生理盐水可作为声窗,金属丝作为追踪目标,采用半自动化超声引导床边经鼻胃空肠管是一种有效的置管方法,在医学工程领域具有较好的临床应用价值。