老年胃癌术后胃肠减压及早期肠内营养置管方式的探讨

To study gastrointestinal decompression and early enteral-intestinal nutrition after operation for elderly gastric cancer

目的探讨老年胃癌术后胃肠减压及早期肠内营养的最佳方法。方法我科2005年1月-2007年1月行老年胃癌手术105例，根据置管情况随机分成普通鼻胃管＋普通空肠营养造口管（或鼻肠管）纽、经鼻置三腔胃肠管组和胃造口置三腔胃肠管组，对3组胃管方法在胃肠减压和早期肠内营养方面进行临床研究和评估。结果术中胃造口置三腔胃肠管进行胃肠减压同时能早期行肠内营养，鼻咽部不适、恶心呕吐、肺炎等并发症发生率明显较低，能较好达到预期营养目标。结论术中胃造口置三腔胃肠管进行胃肠减压和早期肠内营养，并发症低、耐受性好，尤其适合老年胃手术患者。

Objective To explore the best methods about gastrointestinal decompression and EEN for elderly gastric cancer. Methods One hundred and five patients with elderly gastric cancer were randomly divided into three groups. Patients received enteral nutrition via a one-lumen tube（nasojejunal or jejunal ＋nasogasstric tube）, or a Freka@ Trelumina tube by nasoaproach or a Freka@ Trelumina tube by gastric approach. Gastrointestinal decompression and EEN were studied for three groups. Results The patients were feeded by the new three-lumen tube with simultaneous decompression of stomach. Furthermore there were fewer and lighter symptoms in Freka@. Trelumina groups. Conclusion Placement of Freka Trelum during operation is a better technique. It is a safe and successful means for enteral nutrition. It is a better technique fitting for elderly gastric cancer.