保留空肠营养管在胃癌术后化疗期间的应用价值

Application of reserved jejunal feeding tube during postoperative chemotherapy of gastric cancer

目的探讨保留空肠营养管在胃癌术后化疗期间的应用价值。方法总结42例胃癌根治术后行辅助化疗患者的临床资料，术中常规放置空肠营养管，将所有病例按术后病理分期及肿瘤部位随机分为A、B两组，每组各21例，A组保留空肠营养管并在化疗期间经空肠营养管行肠内营养，B组不保留空肠营养管在化疗期间按日常进食，分别比较两组化疗前后营养及免疫指标，比较两组患者呕吐的发生率，观察长期保留空肠营养管的并发症。结果化疗后A组营养及免疫指标较B组明显提高，两组比较差异有统计学意义（P〈0．05）。A组呕吐发生率为18．3％，显著低于B组发生率（35．7％）（χ^2=9．75，P〈0．01）。长期保留空肠营养管未发生严重并发症。结论保留空肠营养管在胃癌术后化疗期间行肠内营养能显著改善患者的营养及免疫状况，且安全可靠，值得推广。

Objective To evaluate the effects of reserved jejunal feeding tube during postoperative chemotherapy of gastric cancer. Methods Forty-two patients with gastric cancer underwent radical gastrectomy and going to adjuvant chemotherapy, conventional placed jejunal feeding tube. All of the patients were divided into group A and group B randomly by pathological staging and tumor site, group A reserved jejunal feeding tube and received enteral nutrition through the tube during chemotherapy, and group B non-reserved jejunal feeding tube and been given daily diet,compared nutrition and immune indicators of two groups before and after chemotherapy, compared the rate of vomiting, and observed complications long-term reserved jejunal feeding tube. Results In post-chemotherapy,nutrition and immune indicators of group A were better than those of group B, the difference was statistically significant （P 〈 0.05 ）, the rate of vomiting in group A was significantly lower than that of in group B （χ^2 = 9.75, P 〈 0.01 ） ,no serious complications occurred forlong-term reserved jejunal feeding tube. Conclusions Reserved jejunal feeding tube and received enteral nutrition through the tube during postoperative chemotherapy of gastric cancer can significantly improve the nutritional and immune status. It is safe and reliable, worth promoting.