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临床对比研究

The clinical study of indwelling nasointestinal feeding tube and enteral nutritional by jejunostomy after total gastrectomy

目的探讨全胃切除术后行肠内营养的最佳方式。方法 60例行全胃切除术的胃癌患者按随机数字表法分为对照组和观察组各30例,分别给予留置鼻空肠营养管与空肠造口两种方式进行肠内营养。观察两组肠内营养的完成情况、恢复情况和营养指标变化。结果对照组2例失败,观察组全部顺利完成;对照组并发症的发生率为30%(9/30),观察组为6.7%(2/30),两组比较差异有显著性(P<0.05);观察组的通气时间、排便时间和住院时间均明显短于对照组,差异有显著性(均P<0.05);观察组术后营养的指标优于对照组,但差异无显著性(P>0.05)。结论全胃切除术后经空肠造口行肠内营养,能明显改善患者的营养状态,相比留置鼻空肠营养管,并发症更少,胃肠功能恢复更快。

【Objective】 To explore the better way to enteral nutrition after total gastrectomy.【Methods】 60 patients with advanced gastric cancer took total gastrectomy were divided into observation group and control group,which respectively given indwelling nasointestinal feeding tube or enteral nutritional by jejunostomy.Enteral nutrition,intestinal function recovery time,and changes in nutritional indicators were compared.【Results】 2 cases in observation group diverted to parenteral nutrition,control group all successfully completed.Complication rate of the control group was 30%（9/30）,observation group was 6.7%（2/30）,adverse reactions were significant（P 0.05）;anal exhaust time and defecation time in observation group were significantly earlier than the control group（P 0.05）;Nutrition indicators of observation group were better than the control group,but no significant differences（P 0.05）.【Conclusion】 Enteral nutrition by jejunostomy after total gastrectomy,can significantly improve the patients nutritional status,with fewer complications and faster recovery of gastrointestinal function.