上消化道穿孔超过24小时后手术并放置空肠营养管27例的临床观察

Clinical Observation of Surgery after Upper Gastrointestinal Perforation More than 24 Hours and Placed Jejunal Feeding Yube of 27 Cases

目的评价上消化道穿孔超过24小时后手术并放置空肠营养管的临床疗效。方法术中行穿孔修补,尽可能地彻底清除腹腔脓液、脓苔,温生理盐水清洗腹腔直至清洁,空肠上段留置空肠营养管。结果 27例患者均未发生修补口瘘、腹腔脓肿、切口感染及短期肠梗阻,平均住院天数13d,一期愈合出院。结论上消化道穿孔超过24小时、腹腔严重污染的患者,术后采用空肠营养管行早期肠内营养。

Objective To assess the effect of the surgery after upper gastrointestinal perforation more than 24 hours and placed jejunal feeding tube.Methods To perform the perforation repair during the surgery,to clear abdominal pus thoroughly as possible as we can,to use saline to wash abdominal cavity until clean,to indwell jejunal feeding tube in the upper jejunum.Results In 27 patients,none of them had repair fistula,abdominal abscess,wound infection,and recent obstruction,the average hospital stay was 13 d,and all were healed and discharged.Conclusions Giving the patients with upper gastrointestinal perforation more than 24 hours,serious pollution of the abdominal cavity the early enteral nutrition by jejunal feeding tube after operation has guiding role in postoperative recovery of the patients.