Li Gang, Lin Jiajia, Liu Yang, Yang Qi, Tong Zhihui, Ke Lu, Li Weiqin
Center of Severe Acute Pancreatitis (CSAP), Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, No. 305 Zhongshan East Road, Nanjing, 210002 Jiangsu, China.
Gastroenterol Res Pract. 2021 Oct 5;2021:4903241. doi: 10.1155/2021/4903241. eCollection 2021.
The optimal technique for nasojejunal tube (NJT) placement in terms of facilitating early enteral nutrition (EN) in patients with acute pancreatitis (AP) is unclear. In this study, we aimed to evaluate the impact of two common techniques on EN implementation and clinical outcomes in a group of AP patients.
This is a retrospective study. All the data were extracted from an electronic database from August 2015 to October 2017. Patients with a diagnosis of AP requiring NJT placement were retrospectively analyzed. The primary outcome was the successful procedural rate.
A total of 53 eligible patients were enrolled, of whom 30 received an ultrasound-assisted technique and the rest received the endoscopy method ( = 23). There was no difference in success rates of initial placement procedures between the two groups (93.3% and 95.7% in the ultrasound-assisted group and endoscopy group, respectively). The mean amount of EN delivery within the first three days after NJT placement was significantly higher in the ultrasound-assisted group (841.4 kcal (95% CI: 738.8, 944 kcal) vs. 652.5 kcal (95% CI: 562.5, 742.6 kcal), = 0.018). Moreover, a slight increased postprocedural intra-abdominal pressure (IAP) was observed in patients undergoing endoscopic procedures, but not in the ultrasound-assisted group, especially at 6 hours after NJT placement (0.35 vs. -2.01 from baseline, < 0.05). For clinical outcomes, we observed no difference between groups.
Compared with endoscopic procedures, ultrasound-assisted NJT placement possesses the acceptable success rates of initial placement procedures.
在急性胰腺炎（AP）患者中，就促进早期肠内营养（EN）而言，鼻空肠管（NJT）置入的最佳技术尚不清楚。在本研究中，我们旨在评估两种常用技术对一组AP患者肠内营养实施情况和临床结局的影响。
这是一项回顾性研究。所有数据均从2015年8月至2017年10月的电子数据库中提取。对诊断为AP且需要置入NJT的患者进行回顾性分析。主要结局是操作成功率。
共纳入53例符合条件的患者，其中30例接受超声辅助技术，其余23例接受内镜检查方法。两组初始置入操作的成功率无差异（超声辅助组和内镜组分别为93.3%和95.7%）。超声辅助组在NJT置入后前三天内的肠内营养输送平均量显著更高（841.4千卡（95%CI：738.8，944千卡）vs.652.5千卡（95%CI：562.5，742.6千卡），P = 0.018）。此外，接受内镜检查的患者术后腹内压（IAP）略有升高，而超声辅助组未出现这种情况，尤其是在NJT置入后6小时（与基线相比为0.35 vs. -2.01，P < 0.05）。对于临床结局，我们观察到两组之间无差异。
与内镜检查相比，超声辅助NJT置入的初始置入操作成功率可接受。
