EXPERIENCE OF INTRANASAL INTRODUCTION OF A NASAL DRAINAGE TUBE BY THE “GUIDEWIRE SINGLE METHOD”

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  • 「ガイドワイヤー単独法」を用いた経鼻ドレナージチューブの鼻腔内誘導法に関する経験

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Conventionally, as a method of introducing an intranasal drainage tube, the “conventional method” using a laryngoscope has been common. However, recently, the usefulness of the “roping method” which uses a soft catheter and a guidewire (GW), and that of the “GW single method” which introduces the tube with only a GW, have been reported. We experienced 110 cases of intranasal introduction of a nasal drainage tube by the “guidewire single method”.<BR>We studied 110 consecutive patients in whom a nasal drainage tube was inserted. We decided to use the “roping method” if the tube could not be inserted by the GW single method within 5 minutes. Furthermore, we decided to perform the “conventional method” if the tube could not be introduced by the roping method within 5 minutes. We measured time A [from the beginning to introduction of the GW outside the oral cavity], time B [from the introduction of the GW outside the oral cavity to final placement of the drainage tube], time C [time A+time B ; from the beginning to the end], and the length of time of undergoing X-ray fluoroscopic observation. We studied the success rate of the “GW single method”, complications, and factors affecting time A to C.<BR>The median time of A, B, and C and of undergoing X-ray fluoroscopic observation were 58.0seconds, 61.0seconds, 124seconds, and 59.5 seconds, respectively. The success rate of the “GW single method” was 99.1%. Serious complications were not recognized. We studied several factors such as age, sex, height, weight, body mass index (BMI), examination type, drainage tube diameter, and physician. BMI was a factor affecting time B. Although the physician was a factor affecting time A to C and the length of time of performing X-ray fluoroscopic observation, this difference was considered to disappear with experience.<BR>The “GW single method” was considered to be a simple method that can be performed safely.

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