【摘要】 目的:比较重症急性胰腺炎(SAP)病人在X线及内镜辅助下放置鼻空肠管的方法。方法:选取52例SAP病人分别采用X线辅助超滑导丝法和内镜辅助下放置鼻空肠管,记录置管成功率,置管时间,置管相关并发症的发生率,置管前、置管中、置管后舒适度(VAS评分)以及留置时间。结果:X线辅助下超滑导丝法较内镜辅助法的置管时间短,VAS评分低,置管相关并发症(腹痛、腹胀)的发生率低(P<0.05);两种方法在置管成功率,其他置管相关并发症(鼻咽部出血、上消化道出血、穿孔、误吸、呼吸困难)以及远期并发症(导管移位、咽炎、鼻窦炎、肺部感染)的发生率、留置时间等差异无显著性意义(P>0.05)。结论:X线辅助下超滑导丝法和内镜辅助法均是SAP病人早期非手术放置鼻空肠管有效、安全、易行的方法。X线辅助下超滑导丝法可作为一般病人的首选方法;对需要机械通气、持续血液滤过治疗以及并发胰性脑病、十二指肠狭窄的SAP病人,内镜辅助法则更合适。更多还原

【Abstract】 Objective: To compare the two methods of naso-jejunal feeding tube placement in patients with severe acute pancreatitis. Methods: 52 patients with SAP were separately placed with naso-jejunal feeding tube by the methods of fluoroscopically stiff type guide wire or endoscope.The successful rate,duration,complications in the procedure,VAS score,and the indwelling time were recorded.Results: Comparing with endoscope,the method of fluoroscopically stiff type guide wire is shorter in the duration,lower in the VAS score,and less in the complications(pain) in the procedure.There were no differences in the successful rate and other complications(bleeding,perforation,dyspnea,pharyngitis,pneumonia,and transposition of the tube).Conclusion: The methods of fluoroscopically stiff type guide wire and endoscope are efficient,save and feasible in placing naso-jejunal feeding tube in patients with SAP.Fluoroscopically stiff type guide wire is the first choice of most patients.The method by endoscope is suitable to the patients treated with mechanical ventilation and CBP,or suffered from pancreatic encephalopathy(PE) and stenosis of duodenum.更多还原