Application of gastroscopy assistant nasal intestinal tube placement and jejunum nutrition in patients with severe internal diseases / 中国内镜杂志

ABSTRACT

Objective To investigate the value of endoscopic assisted nasal jejunal tube placement and jejunum nutrition in treatment of critically illed patients. Methods This study was a prospective study. 56 patients with severe cerebrovascular diseases in the department of NICU from May 2014 to May 2017 were enrolled in this study. All of the patients were found to have an increased gastric remnant within 72 hours after admission (>100 ml). In the nasal jejunal group, 28 patients received nasal endoscopy and nasal endoscopic feeding, and 28 cases were treated with routine nasogastric tube and enteral nutrition. Comparing the two groups of patients with gastrointestinal complications (including vomiting, gastroesophageal reflux, abdominal distension, diarrhea, stress ulcer incidence) and nutritional status parameters (including serum albumin, prealbumin, hemoglobin), incidence of hospital acquired pneumonia and inflammation indexes (including WBC, PCT and CRP), stay at NICU time, NICU expenses, GCS score and mortality rate. Results The success rate of nasal intestinal tube placement under nasal endoscopy guided wire was 100.0%. The nasal jejunal nutrition status parameters were better, NICU check-in time was shorter, NICU expenses were lower, and the inflammation index was lower than the control group. There were no significant differences in the incidence of gastrointestinal complications, the incidence of hospital acquired pneumonia, the GCS score and the fatality rate between the two groups. Conclusion For the patients with severe gastric remnant increase in NICU, it is worth recommending that naso jejunal tube be inserted into the jejunum by endoscopy and using jejunum nutrition.