全胃切除术后经留置鼻空肠营养管与空肠造口行肠内营养的效果比较

Nutrients supply via indwelling nasointestinal feeding tube or enteral nutritional by jejunostomy after total gastrectomy

目的：探讨全胃切除术后经留置鼻空肠营养管与空肠造口行肠内营养的应用效果。方法：选取2006年1月-2010年12月收治的实施全胃切除术的进展期胃癌患者54例,按肠内营养方法不同分为留置鼻空肠营养管组（A组）32例和空肠造口组（B组）22例。比较两组肠内营养完成情况、肠功能恢复时间和营养指标变化。结果：A组有3例改行肠外营养,B组全部顺利完成。B组不良反应较A组明显减少（P〈0.05）,而并发症无显著性差异（P〉0.05）;B组肛门排气时间和排便时间均明显早于A组（P均〈0.05）,两组营养指标术后比较无显著性差异（P均〉0.05）。结论：全胃切除术后经空肠造口行肠内营养,操作简便,能明显改善患者的营养状态,且相比留置鼻空肠营养管,患者痛苦更小,胃肠功能恢复更快,值得临床推广应用。

Objective： To investigate the effects of nutrients supply via indwelling nasointestinal feeding tube or enteral nutrition support by catheter jejunostomy after total gastrectomy.Methods： Fifty-four patients with advanced gastric cancer that underwent total gastrectomy in our hospital from January 2006 to December 2010 were divided into nasointestinal feeding tube group（group A,32 cases） and jejunostomy group（group B,22 cases）.Status of enteral nutrition,time for intestinal function recovery,and changes in nutritional indicators were compared between the two groups.Results： Nutrients supply in 3 cases of group A failed and had to apply enteral nutrition support by catheter jejunostomy,but enteral nutrition were all completely successfully in all cases.Side effects observed in group B was significantly less than that in group A,but no significant differences in complications were observed（P0.05）.Time for patients to restore functions in flatus and defecation in group B was shorter than that in group A（P all 0.05）.No significant difference in nutritional indicators was observed between the two groups（P0.05）.Conclusions： Enteral nutrition support by catheter jejunostomy can improve patients′ nutrients status for patients underwent total gastrectomy,it′s also simple to be operated and cause less pains comparing with nutrients supply via indwelling nasointestinal feeding tube.