• 성인간호학회지
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• 제26권5호
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• pp.592-602
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• 2014

Purpose: This study was to provide understanding about the meaning of nasogastric tube feeding experiences by the cerebral stoke patients with dysphagia. Methods: Data were collected through a face to face interview from five cerebral stroke patients who had dysphagia along with a nasogastric tube insertion. The contents of the interviews were analyzed using the hermeneutics phenomenological method developed by van Manen. Results: The experience of having a nasogastric tube was not only limited to physical problems but also was linked to other psychological problems. Many patients reported that they tolerated the nasogastric tube in order to overcome the stroke along with the desire to eventually take food orally. The essential themes associated with the experience of nasogastric tube insertion were: "The loss of pleasure from food", "The loss of human relationship from surrounding table", "Cower and shrink from the different appearance to others" and "Acceptance for life in painful experiences". Conclusion: This study would highlights the importance of not only physical focused care but also psychological and social aspects. Therefore, nurses should consider all factors when providing nursing care to stroke patient with nasogastric tube feeding.

• 성인간호학회지
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• 제13권1호
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• pp.136-147
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• 2001

Dysphagia is common and serious problem in intracerebral hemorrhage patients. Nasogastric-tube intubation is an important method for dysphagic patients who have an intracerebral hemorrhage. But many discomforts develope in patients with a nasogastric-tube. Therefore, it is necessary to decide when to remove the tube and as early as possible. The purpose of this study is to decide the applying time of training program to facilitate deglution for dysphagic patients who have intracerebral hemorrhage. Among the 343 patients with intracerebral hemorrhage who had been admitted to P-university hospital from April, 1994 to December, 1998, the medical record of the 110 patients with nasogastric tube were reviewed retrospectively. Results from the study were as follows: 1. Nasogastric tube insert duration of improved patients was a mean of 23.2 days 2. When a L-tube was inserted and removed, the L.O.C. of improved patients was $2.6{\pm}0.8$(in the midst of stupor or a semicoma),$1.9{\pm}0.5$(close to drowsy), respectively. This was signifcantly different(P=0.000). 3. When a L-tube was inserted and removed, GCS of improved patients was $9.3{\pm}2.9$, $12.1{\pm}2.2$ respectively. This was significantly different (P=0.000). 4. The duration of nasogastric tube insertion was the longest when in a stupor(L.O.C), 6~8 points(GCS).

• 간호행정학회지
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• 제8권4호
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• pp.645-654
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• 2002

Purposes : This study was conducted to examine nursing effects after using a new method of nasogastric tube feeding with recycled PETE bottle making use of gravity, and to compare with those of bolus method using syringe and pressure. Methods : The data collected from patients with nasogastric tube feeding more than a week at an internal medicine unit of C university hospital located in G-city from January 1st, 1998 through June 30th, 2000. For this nonequivalent control group posttest non-synchronized design, 28 patients were assigned to an experimental group and 35 patients to a control group. The homogeneity of two groups and the dependent variables were tested with use of $x^2-test$ and t-test. Results : The duration of hemostatic use was significantly shorter in the experimental group than control group(t=2.63, p=0.02). Also, the patients with PETE bottle feeding had a lower cost of material(t=3.51, p=0.01) and a lower rate of the time of direct nursing care(t=2.44, p=0.04) than those of control group. But, there was no significant difference between two groups in the length of hospital stay. Conclusion : This results indicates that nasogastric tube feeding with PETE bottle is superior to nasogastric tube feeding with syringe. This findings gave us an evidence to enhance nursing effectiveness in clinical setting.

• 한국방사선학회논문지
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• 제9권1호
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• pp.1-7
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• 2015

뇌경색, 뇌 신경장애 및 뇌졸중환자 중 급성기 환자는 의식이 없어 연하기능장애로 인한 흡인성 폐렴을 유발하기 때문에 비위관(nasogastric tube)을 삽입하고 영양공급을 한다. 재활훈련 후 회복기에 침상선별검사를 시행하지만 임상적 검사를 통해서는 무증상흡인은 발견할 수 없다. 그래서 연하장애로 비위관을 삽입한 연하재활치료 중인 환자 10명을 대상으로 VFSS를 시행하여 식이재료에 따른 삼킴 정도, 자세에 따른 삼킴을 재활의학과전문의가 평가 후, 흡인이 있거나 삼킴 곤란 등이 있으면 연하재활치료를 시행하여 환자의 상태에 따라 약 30일~50일후에 재평가를 시행한 후 흡인이 없을 시 비위관을 제거 하였다. 이때 VFSS 영상을 기능적 연하곤란척도를 이용, 분석하여 부여된 점수를 통계 산출 하였는데 비위관 유지군은 $49.79{\pm}9.431$을 보여 흡인의 위험을 나타내며, 비위관 제거군은 $11.20{\pm}1.932$로 흡인의 위험성이 낮아 비위관 제거관련 의미 있게 낮은 점수를 보였다. 두 군의 유의성을 평가하기 위해 Mann-Whitney test를 시행한 결과 p<0.001로 통계적으로 유의하다고 평가하였다. 결론적으로 VFSS는 구강, 인두, 식도의 구조적 이상과 움직임을 가장 효과적으로 평가, 기도흡인여부를 즉시 확인 및 환자에게 적합한 식이나 연하자세를 결정할 수 있어 비위관 제거를 위한 연하평가에 가장 확실한 표준검사로 제안할 수 있다.

• 대한간호학회지
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• 제37권4호
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• pp.558-567
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• 2007

Purpose: This study was to identify the effects of oropharyngeal sensory stimulation on a functional oral intake scale, ore-pharyngeal swallowing functions, and aspiration pneumonia symptoms with nasogastric tube insertion in stroke patients. Method: This study was a nonequivalent control group non-synchronized design. The subjects or the study were 32 patients who were hospitalized in Kosin Gaspel hospital. The experimental subjects were stimulated for $10{\sim}20$ minutes, 1 time per day. The intervention was implemented for 2 weeks. Result: Participants in the experimental group significantly received a higher score in ore-pharyngeal swallowing function than those in the control group. However the participants in the experimental group only got a high score in the function oralintake scale which doesn't imply a statistical significance. In addition, they didn't geta remarkably higher score in aspiration pneumonia symptoms than those in the control group. Conclusion: This study demonstrates that oropharyngeal sensory stimulation is effective in promoting recovery oro-pharyngeal swallowing function of nasogastric tube insertions in stroke patients.

• Journal of Korean Biological Nursing Science
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• 제10권2호
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• pp.105-112
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• 2008

Purpose: The purpose of this study was to investigate the difference in the incidence of diarrhea among the subjects given hypertonic and isotonic nutrients to the nasogastric tube feeding patients in the a critical care setting. Methods: This study is aquasi-experimental study with a pre & post-test design. The sample size of 40 was calculated based on Cohen's formula (1988). The total of 40 subjects who signed the informed consent were randomly selected and divided evenly into two groups, experimental and control group. Results: There are no significant differences between the two groups in homogeneity test (sex, age, albumin level, the use of antibiotics, antacid, and $H_2$ blocker). However, the frequencies of occurrence in diarrhea according to the density of nutrients formulation indicated a statistical difference at the level of .005 (p=.001): diarrhea occurred in four of 20 (20%) of the experiment group, but 14 (70%) of the control group. Also the onset date of diarrhea in the experiment group is later than that of the control group. Conclusion: The research findings suggest that we should begin with low density nutrients for nasogastric tube feeding, and increase its density gradually to decrease diarrhea incidence in the critical care setting.

• 대한후두음성언어의학회지
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• 제31권2호
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• pp.83-86
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• 2020

Patients with tracheoesophageal fistula show signs of aspiration, possibly leading to pneumonia, which could be fatal to bed-ridden patients. Tracheoesophageal fistula occurs as a complication of intubation, tracheostomy tube insertion and nasogastric tube insertion. Possible etiology is pressure and ischemic necrosis given by tracheostomy tube and nasogastric tube to trachea and esophagus; or in some cases, larynx and hypopharynx. Meanwhile, for repair of tracheoesophageal fistula, transcervical approach can be considered but takes relatively long operation time and is not appropriate for patients with underlying diseases. We report a case of tracheoesophageal fistula complicated several years after tracheostomy tube and nasogastric tube insertion who came to medical attention with signs of aspiration. Authors successfully performed repair of the fistula under laryngeal microsurgery approach without skin incision and dissection, and thereby report the experience with review of literature.

• Clinical Endoscopy
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• 제56권4호
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• pp.391-408
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• 2023

With an aging population, the number of patients with difficulty in swallowing due to medical conditions is gradually increasing. In such cases, enteral nutrition is administered through a temporary nasogastric tube. However, the long-term use of a nasogastric tube leads to various complications and a decreased quality of life. Percutaneous endoscopic gastrostomy (PEG) is the percutaneous placement of a tube into the stomach that is aided endoscopically and may be an alternative to a nasogastric tube when enteral nutritional is required for four weeks or more. This paper is the first Korean clinical guideline for PEG developed jointly by the Korean College of Helicobacter and Upper Gastrointestinal Research and led by the Korean Society of Gastrointestinal Endoscopy. These guidelines aimed to provide physicians, including endoscopists, with the indications, use of prophylactic antibiotics, timing of enteric nutrition, tube placement methods, complications, replacement, and tube removal for PEG based on the currently available clinical evidence.

• 한국콘텐츠학회:학술대회논문집
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• 한국콘텐츠학회 2014년도 추계 종합학술대회 논문집
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• pp.189-190
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• 2014

뇌경색, 뇌 신경장애 및 뇌졸중환자 중 급성기 환자는 의식이 없어 연하기능장애로 인한 흡인성 폐렴을 유발하기 때문에 비위관(nasogastric tube)을 삽입하고 영양공급을 한다. 재활훈련 후 회복기에 침상선별검사를 시행하지만 임상적 검사를 통해서는 무증상흡인은 발견할 수 없다. 그래서 연하장애로 비위관을 삽입한 연하재활치료 중인 환자 10명을 대상으로 VFSS를 시행하여 식이재료에 따른 삼킴 정도, 자세에 따른 삼킴을 재활의학과전문의가 평가 후, 흡인이 있거나 삼킴 곤란 등이 있으면 연하재활치료를 시행하여 환자의 상태에 따라 약 30일 ~ 50일후에 재평가를 시행한 후 흡인이 없을 시 비위관을 제거 하였다. 이때 VFSS 영상을 기능적 연하곤란척도를 이용, 분석하여 부여된 점수를 통계 산출 하였는데 비위관 유지군은 $49.79{\pm}9.431$을 보여 흡인의 위험을 나타내며, 비위관 제거군은 $11.20{\pm}1.932$로 흡인의 위험성이 낮아 비위관 제거관련 의미 있게 낮은 점수를 보였다. 두 군의 유의성을 평가하기 위해 Mann-Whitney test를 시행한 결과 p<0.001로 통계적으로 유의하다고 평가하였다. 결론적으로 VFSS는 구강, 인두, 식도의 구조적 이상과 움직임을 가장 효과적으로 평가, 기도흡인여부를 즉시 확인 및 환자에게 적합한 식이나 연하자세를 결정할 수 있어 비위관 제거를 위한 연하평가에 가장 확실한 표준검사로 제안할 수 있다.

• Journal of Chest Surgery
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• 제30권11호
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• pp.1142-1144
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• 1997

혈관륜이 있는 경우 드물게 동맥 식도루가 발생하여 대출혈이 발생할 수 있다. 42세 남자환자가 교통사고 후 7주간 비위관을 삽입하고 있던 중 상부 위장관 출혈이 발생하여 응급수술을 하였다. 수술 소견상 우측 쇄골하동맥 기시이상이 있었으며 오랜 비위관 상관으로 발생된 것으로 생각되는 동맥-식도루가 있어 이를 수술교정 하였다. 술후 환자상태는 안정 되었으나 술후 5일째 흉관 자극과 염증에 기인 하는 대동맥 봉합부위의 출혈이 발생하여 재수술을 하였고 의식불명 상태로 술후 8일째 사망하였다.