术后胃轻瘫肠内营养及镜下置管

Study of enteral nutrition and nutritional duct implant by gastroscopy in patients with postsurgical gastrparesis syndrome

目的观察肠内营养与静脉营养对胃瘫患者胃肠功能恢复时间的影响及探讨胃镜下放置营养管的方法。方法17例胃轻瘫患者,6例行全静脉营养,11例胃镜下置管行肠内营养。其中5例7次放置鼻空肠营养管,8例用鼻胆管经胃镜活检孔道放置代替鼻空肠管。结果11例EN患者胃肠功能恢复时间术后(15±0.95)d,较6例全静脉营养(26±2.65)d,明显缩短,t检验P<0.001。两种置管方法操作时间鼻空肠管(49.0±7.0)min和“鼻胆管”(5.5±1.2)min,两者比较t检验,P<0.001,差异有统计学意义。结论胃瘫患者早期行肠内营养比静脉营养能明显缩短胃肠功能恢复时间,对病人术后康复极为有利。内镜下放置鼻胆管代替鼻空肠管能明显缩短放置时间,且操作容易,成功率高,易被患者接受。

[Objective] To observe the effect of enteral nutrition and intravenous nutrition on the gastrointestinal function restoration time and investigate the methods of nutritional duct plant with gastroscopy. [Methods] 11 patients with postsurgical gastroparesis syndrome were given enteral nutrition by nutritional duct plant with gastroscopy once diagnosis was made. Parenteral nutrition was given to 6 patients. 5 cases （7 times） of the 11 patients were planted naso-intestinal tube into jejunum by gastroscopy. Nasal bile duct was planted in another 8 patients. [Resuits] Gastrointestinal function restoration time in EN group was （15±0.95） d; PN group was （26±2.65） d. the time spent during nutritional duct plant in naso-intestinal tube group was （49.0±7.0） mins and （5.5±1.2） mins in nasal bile duct. Significant difference was found between two groups （P 〈0.001）. [Conclusions] Compared with intravenous nutrition, early enteral nutrition may significantly shorten the gastrointestinal restoration time in gastroparesis and benefit to the postoperation recovery. Nasal bile duct implant by gastroscopy replace the naso-intestinal tube significantly shorten the implantation time and palliate the pain during operation that may be easily accepted and finished.