Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
Dig Dis Sci. 2020 Jan;65(1):225-231. doi: 10.1007/s10620-019-05741-0. Epub 2019 Jul 31.
BACKGROUND/AIMS: Spontaneous retrograde migration of nasoenteral feeding tubes is common in clinical practice. The aim of the present study was to evaluate the effectiveness of nasoenteral feeding tube tip fixation with hemoclips to prevent tube dislodgement.
We retrospectively reviewed patients who underwent insertion of an endoscopic nasoenteral feeding tube with or without tube tip fixation with hemoclips at the Asan Medical Center in Korea from January 2016 to December 2017. We compared the incidence of tube dislodgment and procedure-related complications between the two groups.
Of the total 225 procedures, 72 were performed using the clip-assisted method, while 153 were performed using the standard non-clip-assisted method. Tube dislodgement occurred in two (2.8%) cases in the clipping group and in 26 (17.0%) in the non-clipping group (p = 0.003). Non-clipping group had a sevenfold higher risk of tube dislodgement compared to clipping group after adjustments in multivariable logistic regression (adjusted OR 7.97, 95% CI 1.82-35.00). The procedure time was not significantly different between the two groups (17.6 ± 8.5 min in the clipping group vs. 17.8 ± 9.4 min in the non-clipping group, p = 0.872). In addition, procedure-related complications, such as bleeding, aspiration pneumonia, Mallory-Weiss tear, ileus, and tube obstruction, were not different between the two groups. Achieving target calorie intake took 10.4 ± 10.5 days in the clipping group and 7.9 ± 7.9 days in the non-clipping group (p = 0.293).
Clip-assisted fixation of nasoenteral feeding tube was effective in preventing tube dislodgement.
背景/目的：在临床实践中，鼻肠喂养管的自发性逆行迁移很常见。本研究的目的是评估使用血管夹固定鼻肠喂养管尖端以防止管脱出的效果。
我们回顾性分析了 2016 年 1 月至 2017 年 12 月在韩国峨山医疗中心接受内镜鼻肠喂养管插入术的患者，其中 72 例采用夹辅助方法，153 例采用标准非夹辅助方法。我们比较了两组管脱出和与操作相关的并发症的发生率。
在总共 225 例操作中，夹辅助组有 2 例（2.8%）发生管脱出，而非夹辅助组有 26 例（17.0%）发生管脱出（p=0.003）。在多变量逻辑回归调整后，非夹辅助组管脱出的风险是非夹辅助组的 7 倍（调整后的 OR 7.97，95%CI 1.82-35.00）。两组的操作时间无显著差异（夹辅助组 17.6±8.5 分钟，非夹辅助组 17.8±9.4 分钟，p=0.872）。此外，两组之间的操作相关并发症，如出血、吸入性肺炎、Mallory-Weiss 撕裂、肠梗阻和管阻塞，没有差异。夹辅助组达到目标热量摄入的时间为 10.4±10.5 天，而非夹辅助组为 7.9±7.9 天（p=0.293）。
鼻肠喂养管的夹辅助固定可有效防止管脱出。
