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題名 | 標準經鼻胃管置放術的修正:經口咽處操作導引法=A Modification of Standard Nasogastric Tube Insertion: Trans-oropharyngeal Manipulation Guiding Method |
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作者 | 陳建志; 陳登郎; 鄒永恩; Chen, Jiann-jy; Chen, Dem-lion; Tsou, Yung-an; |
期刊 | 臺灣家庭醫學雜誌 |
出版日期 | 20160900 |
卷期 | 26:3 2016.09[民105.09] |
頁次 | 頁162-168 |
分類號 | 419.73 |
語文 | chi |
關鍵詞 | 鼻胃管置入術; 吞嚥不良; 失智症; 腦中風; Dementia; Dysphagia; Nasogastric tube insertion; Stroke; |
中文摘要 | 目的:臨床經常遇到經鼻胃管困難置放的患者,特別是在患者不能配合吞嚥動作、昏迷或是已插上氣管內管時。我們提出一個改良後的方法,有助於臨床醫護人員更能成功地進行鼻胃管置放術。方法:當鼻胃管到達患者口咽部時,右手食指與中指伸入患者口中,利用兩指尖端間的空間,把胃管直接送進食道入口,需製作防咬器避免被患者咬傷。結果:在2012年8月至2014年9月間,共有22名患者(12男10女)接受此方法,年齡67.1±16.0歲(平均值±標準差),僅有1人失敗須會診耳鼻喉科醫師以軟式纖維鼻咽喉內視鏡協助置入。結論:本文提出另一項經鼻胃管置放修正,過程中不需配合患者的吞嚥動作,尤其適用於功能性的吞嚥不良患者,做為標準方法失敗後的即時性選擇。 |
英文摘要 | Purpose: In clinical practice, it is not uncommon patients with difficulties undergoing nasogastric tube insertion, especially those in a comatose state, having problems submitting to swallow, or receiving endotracheal intubation. This study accordingly proposed a modified method to render the procedure less difficultly and more successfully. Methods: As the gastric tube reached a patient's oropharynx, the physician protruded his or her right middle and index fingers into the patient's mouth, directly guiding and pushing the tube into the esophageal orifice. A bite block should be used to prevent the physician from being bitten by the patient. Results: From August 2012 to September 2014, the modified method was applied to 22 patients (12 men and 10 women) aged 67.1±16.0 (mean±SD). Failure occurred in only one person for whom an otorhinolaryngologist was consulted to help complete the insertion with the aid of a fiberooptic nasopharyngoscope. Conclusion: This study introduces an alternative manipulation for nasogastric tube insertion, especially for those with functional dysphagia who could not submit to a standard method. The manipulation, modified from the known standard method, does not require the patient's swallowing action. |
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