Clary E M, Hardie E M, Fischer W D, Kyles A E
Department of Companion Animals and Special Species, North Carolina State University, Raleigh, USA.
J Vet Intern Med. 1996 Jan-Feb;10(1):15-20. doi: 10.1111/j.1939-1676.1996.tb02018.x.
Nonendoscopic tube gastrostomy was performed on 47 anesthetized dogs using the technique of Fulton and Dennis with or without gastric insufflation prior to tube placement. Immediately after tube placement, dogs were euthanized and postmortem examinations performed. When gastric insufflation was not performed (group I), gastrostomy tubes penetrated the visceral surface of the stomach in 25% of dogs. The deep leaf of the omentum was interposed between stomach and body wall in the majority of these dogs, exposing other intra-abdominal organs to potential injury. Additionally, displacement and tethering of the spleen cranial to the gastrostomy site were observed in 33% of dogs in group I. Similar results were obtained when preplacement gastric insufflation was performed after the orogastric tube was inserted sufficiently far to displace the stomach laterally against the body wall (group II). In contrast, consistent positioning of gastrostomy tubes through the parietal surface of the stomach was achieved when the stomach was insufflated prior to lateralizing the left abdominal wall with the gastric end of the orogastric tube (group III). It was concluded that the blind percutaneous gastrostomy technique is made safer by insufflating the stomach immediately prior to pushing the gastric wall laterally into contact with the parietal peritoneum.
在47只麻醉犬身上采用富尔顿和丹尼斯技术进行非内镜下胃造口术，置管前有无进行胃充气。置管后立即对犬实施安乐死并进行尸检。当未进行胃充气时（第一组），25%的犬胃造口管穿透胃的脏面。在这些犬中的大多数，大网膜深层叶介于胃和体壁之间，使其他腹腔内器官有潜在损伤风险。此外，第一组中33%的犬观察到脾脏向胃造口部位头侧移位并被牵拉。当经口胃管插入足够深以将胃向外侧推抵体壁后再进行置管前胃充气时，也得到了类似结果（第二组）。相比之下，当用经口胃管的胃端使左腹壁侧移之前先对胃进行充气时，胃造口管能始终如一地穿过胃的壁面（第三组）。得出的结论是，在将胃壁向外侧推使其与壁层腹膜接触之前立即对胃进行充气，可使盲法经皮胃造口术更安全。
