Digital subtraction angiography combined with wire guidance versus gastroscopy in enteral nutrition catheterization in patients with special diseases of the upper gastrointestinal tract / 中国基层医药

ABSTRACT

Objective:To investigate the efficacy of digital subtraction angiography combined with wire guidance versus gastroscopy in enteral nutrition catheterization in patients with special diseases of the upper gastrointestinal tract. Methods:We recruited 120 patients with special diseases of the upper gastrointestinal tract who underwent enteral nutrition catheterization in Yuyao People's Hospital from January 2016 to July 2020. These patients had gastric outlet obstruction ( n = 40), esophageal obstruction ( n = 39), tracheoesophageal fistula and mediastinal-esophageal fistula ( n = 26), or anastomotic fistula or anastomotic stenosis ( n = 15) after esophageal and gastric surgery. They were randomly allocated into the control and study groups ( n = 60/group). The control group was subject to enteral nutrition catheterization under the guidance of gastroscopy. The study group was subject to enteral nutrition catheterization using digital subtraction angiography combined with wire guidance. We compared the success rate of enteral nutrition catheterization, the time to successful enteral nutrition catheterization, changes in vital signs (such as heart rate, respiratory rate, mean arterial pressure, and blood oxygen saturation) after catheterization relative to before catheterization, and the incidence of adverse reactions between the two groups. Results:The success rate of enteral nutrition catheterization was significantly higher in the study group than in the control group (86.67% vs. 65.00%, χ2 = 7.68, P = 0.006). The time to successful enteral nutrition catheterization in the study group was significantly shorter than that in the control group [(28.61 ± 3.37) minutes vs. (39.75 ± 4.61) minutes, t = -8.92, P < 0.001]. During enteral nutrition catheterization, heart rate, respiratory rate, and mean arterial pressure in the control group were significantly increased compared with before enteral nutrition catheterization ( t = 5.07, 6.85, 4.96, all P < 0.001). During enteral nutrition catheterization, the heart rate and respiratory rate were significantly higher in the control group than in the study group ( t = 3.45, 3.29, both P < 0.001). After enteral nutrition catheterization, the incidence of adverse reactions was significantly lower in the study group than in the control group (13.33% vs. 33.33%, χ2 = 6.70, P = 0.010). Conclusion:Digital subtraction angiography combined with wire guidance can increase the success rate of enteral nutrition catheterization in patients with special diseases of the upper gastrointestinal tract, shorten the time to successful enteral nutrition catheterization, increase patient tolerance to catheterization, and reduce adverse reactions.