鼻胃管的放置穿孔鼻喉,导致中通道和进腹空间
Muhammad Zafran1, Rebecca Crook2, Alexander Tuck2
1Respiratory Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK zafran_amc@yahoo.com.
BMJ case reports
|March 21, 2024
概括
在多发性硬化症患者中,用于食的鼻胃管插入导致了严重的并发症,包括穿孔和腔空间迁移. 这突出了与常规管道安置相关的风险,以及解释X射线确认的挑战.
科学领域:
- 医学案例研究 医学案例研究
- 胃肠病学 胃肠病学
- 放射学 放射学是一门学科.
背景情况:
- 一名患有原发性进展性多发性硬化症的患者患上了吸入性肺炎,需要鼻胃管养.
- 患者的意识下降需要插入鼻胃管以提供营养支持.
研究的目的:
- 报告从鼻胃管插入中产生的罕见而严重的并发症.
- 为了强调通过胸部X射线确认鼻胃管放置的诊断挑战.
主要方法:
- 鼻胃管插入用于肠道养.
- 使用胸部X射线 (CXR) 来验证管尖的初始评估.
- 通过胸部CT扫描进行诊断确认和解剖评估.
主要成果:
- 胸部X射线表明鼻胃管的非典型但可能的胃位置.
- CT扫描显示了鼻孔与管的中间体和膜迁移.
- 患者出现了肺和肺胸,需要进行重大的医疗和手术干预.
结论:
- 鼻胃管插入,尽管是常规的,但存在严重并发症的风险,如中腔穿孔.
- 对于鼻胃管位置的胸部X射线解释可能是不可靠的,特别是在有解剖学变异的病例中,如间隙.
- 临床团队必须谨慎行事,并考虑先进的成像,当怀疑管放置,以防止不良事件.
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