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目的:比较数字减影血管造影（DSA）联合导丝引导与胃镜辅助用于上消化道特殊疾病患者肠内营养置管的效果。方法:选择2016年1月至2020年7月于余姚市人民医院接受肠内营养治疗的上消化道特殊疾病患者120例（胃癌梗阻40例，食管梗阻39例，食管气管瘘及食管纵隔瘘26例，食管及胃外科术后吻合口瘘或吻合口狭窄15例）为研究对象，按照随机数字表法将研究对象分为对照组（60例）和研究组（60例）。对照组实施胃镜引导下置管，研究组实施DSA联合导丝引导下置管。比较两组患者胃肠营养管置管成功率、置管操作耗时，比较两组患者置管操作前后心率、呼吸频率、平均动脉压和血氧饱和度等生命体征指标变化，观察患者置管后不良反应发生情况。结果:研究组患者置管成功率（86.67%）显著高于对照组水平（65.00%）（χn 2=7.68，n P=0.006）；研究组患者肠内营养置管操作耗时为（28.61±3.37）min，显著短于对照组的（39.75±4.61）min（n t=-8.92，n P < 0.001）；置管操作过程中，对照组患者心率、呼吸频率和平均动脉压等均较置管前显著升高（ n t=5.07、6.85、4.96，均n P < 0.001），且对照组患者心率、呼吸频率均显著高于研究组（ n t=3.45、3.29，均n P < 0.001）；研究组置管后不良反应总发生率（13.33%）显著低于对照组（33.33%）（χ n 2=6.70，n P=0.010）。n 结论:DSA联合导丝引导技术可有效提高上消化道特殊疾病患者肠内营养置管成功率，缩短置管操作时间，增加患者置管耐受性，减少不良反应。“,”Objective:To investigate the efficacy of digital subtraction angiography combined with wire guidance n versus gastroscopy in enteral nutrition catheterization in patients with special diseases of the upper gastrointestinal tract.n 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 n = 40), esophageal obstruction (n n = 39), tracheoesophageal fistula and mediastinal-esophageal fistula (n n = 26), or anastomotic fistula or anastomotic stenosis (n n = 15) after esophageal and gastric surgery. They were randomly allocated into the control and study groups (n 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.n Results:The success rate of enteral nutrition catheterization was significantly higher in the study group than in the control group (86.67% n vs. 65.00%, n χ2 = 7.68, n 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 n vs. (39.75 ± 4.61) minutes, n t = -8.92, n 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 ( n t = 5.07, 6.85, 4.96, all n 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 ( n t = 3.45, 3.29, both n 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% n vs. 33.33%, n χ2 = 6.70,n P = 0.010).n 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.