使用新型鼻胃导管向小肠内引入空气介质进行小肠CT仿真内镜检查的研究

摘要

Objective To analyze the safety,efficacy and feasibility of self-made nasogastric tube which was used for the small bowel computed tomographic virtual endoscopy. Method Totally 63 patients undergoing computed tomo-graphic enteroclysis with the contrast medium of air were included,33 patients used the self-made new type nasogas-tric tube to introduce air into lumen and 30 cases used normal stomach tube assisted by electronic gastroscope. Anal-ysis and compare catheterization success rate,operating time,degree of patient’ s discomfort,incidence of adverse re-actions and intestinal filling degree between two groups of patients. Result The catheterization success rate was not significantly different among two groups (P=0. 615). The average operating time of self-made nasogastric tube group was (10. 0±4. 4) minutes,and in the other group it was (15. 2±6. 0) minutes,the difference was statistically significant (P=0. 01). The intestinal filling degree was not significantly different among two groups(P=0. 480). In self-made nasogastric tube group, 26 cases of 4 scores,7 cases of 3 scores;in normal stomach tube assisted by elec-tronic gastroscope group,3 cases of 4 scores,17 cases of 3 scores,10 cases of 2 scores,the degree of patient’ s dis-comfort was significantly different among two groups(P<0. 001). Conclusion During the process of small bowel computed tomographic virtual endoscopy,the new type nasogastric tube can be quickly inserted into duodenal de-scending part through nostril without vision with the advantages of easy operation,consuming less time,better toler-ance and less pain,compared with the traditional tube technology.%目的：评估自制新型鼻胃导管进行小肠CT仿真内镜检查的安全性、有效性及可行性。方法纳入行以空气为介质的CT仿真小肠镜检查的患者63例,其中使用自制新型鼻胃导管引入空气介质患者33例,电子胃镜辅助普通鼻胃导管引入空气介质30例。分析比较两组患者置管成功率、操作时间、患者不适程度、不良反应的发生率及小肠充盈程度的差异。结果两组患者一次性置管成功率差异无显著性(P=0.615)。使用新型鼻胃导管进行空气介质引入组平均置管时间为(10.0±4.4)分钟,电子胃镜辅助普通鼻胃导管引入空气介质组平均操作时间为(15.2±6.0)分钟,差异有显著性(P=0.01)。两组患者小肠充盈程度差异无显著性(P=0.480)。依据患者腹胀、腹痛、恶心、呕吐等不良反应的发生情况对患者不适程度进行评分,使用新型鼻胃导管进行空气介质引入组中评分为4分者26例,3分者7例,使用电子胃镜辅助普通鼻胃导管进行空气介质引入组中评分为4分者3例,3分者17例,2分者10例,两组患者不适程度评分比较有统计学意义(P<0.001)。结论使用新型鼻胃导管可在盲法下快速将导管末端经鼻置入十二指肠降部,较传统电子胃镜下辅助置管技术的操作时间短,患者耐受性更高、不适程度低,操作更简便,该技术提高了患者依从性,更利于临床应用推广。