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[目的]探讨经胃镜孔道直视下放置新型鼻肠饲养管治疗重症急性胰腺炎(SAP)的临床应用价值及其安全性。[方法]回顾性分析96例SAP患者不同方法放置鼻肠饲养管的情况,75例采用新型鼻肠饲养管(DM组),经胃镜孔道直视下放置至空肠上段,经口鼻转换固定后行肠内营养;21例采用内镜下活检钳夹法(CM组)。观察2组放置鼻肠饲养管有效性、成功率、操作时间、鼻肠饲养管通畅时间及并发症差异。[结果]DM组、CM组置管成功率分别为100%(75/75)、95.2%(20/21),2组置管成功率比较差异无统计学意义(P>0.05)。DM组、CM组一次性成功置管至空肠上段者分别为69例、10例,2组比较差异有统计学意义(χ~2=18.542,P<0.01);DM组、CM组平均操作时间分别为(4.91±1.68)min、(23.76±6.07)min,差异有统计学意义(t=24.908,P<0.01);2组鼻肠管均可维持较长通畅期,二者间差异无统计学意义(t=-1.897,P>0.05);均无明显操作相关并发症发生。[结论]经内镜孔道直视下放置新型鼻肠饲养管简单、成功率高、操作时间短,值得临床推广应用。
[Objective] To explore the clinical value and safety of nasobiliary feeding tube placed under endoscopy under endoscopy in the treatment of severe acute pancreatitis (SAP). [Methods] A retrospective analysis of 96 cases of SAP patients placed in different ways nasogastric feeding tube, 75 cases using a new type of nasogastric feeding tube (DM group), placed under direct gastroscopy porthole to the upper jejunum, after oral and nasal conversion fixed Enteral nutrition was performed in 21 cases. Endoscopic biopsy was performed in 21 cases (CM group). The effectiveness of the nasogastric feeding tube, the success rate, the operating time, the patency of the naso-intestinal feeding tube and the complications were observed. [Results] The success rates of catheterization in DM group and CM group were 100% (75/75) and 95.2% (20/21), respectively. There was no significant difference in success rate between two groups (P> 0.05). In DM group and CM group, 69 cases were successfully treated one time from the CM group to the upper jejunum. The difference between the two groups was statistically significant (χ ~ 2 = 18.542, P <0.01). The average operating time (4.91 ± 1.68) min and (23.76 ± 6.07) min, respectively, the difference was statistically significant (t = 24.908, P <0.01). There was no significant difference between the two groups Significance (t = -1.897, P> 0.05); No significant complications occurred. [Conclusion] The new nasogastric feeding tube placed under the direct view of the endoscopic hole is simple, the success rate is high, and the operation time is short, which is worthy of clinical application.