三腔喂养管在老年低肺功能胃癌患者术中的临床应用及护理

Clinical application and nursing of three cavity feeding tube in elderly low pulmonary function patients with gastric cancer

目的比较三腔喂养管与普通胃管在治疗老年低肺功能胃癌手术治疗中的临床应用效果,探讨围手术期护理方法。方法选取2009年12月-2012年12月绵阳市中心医院外科收治的204例年龄>60岁肺低功能胃癌患者,进行有效的术前肺功能锻炼后,肺功能改善后重新评估均达到临床手术指标,按安置胃管方式不同分为三腔喂养管手术组(A组)100例,普通胃管手术组(B组)104例。观察2组临床效果、术中及术后情况。结果 2组均顺利完成根治手术,术后无吻合口瘘,无围术期死亡。2组患者术中出血、手术时间比较差异均无统计学意义(P>0.05);A组术后肛门排气时间、肛门排便时间及住院时间短于B组,心律失常、肺部并发症发生率低于B组,差异均有统计学意义(P<0.05)。结论三腔喂养管空肠营养应用在老年低肺功能胃癌手术中,通过围术期精心治疗和护理可以降低部分并发症发生率,可缩短住院时间。

Objective To compare the clinical application effect of three cavity feeding pipe and normal gastric tube in the treatment of elderly low pulmonary function patients with gastric cancer,and discuss the perioperative nursing methods. Methods From 2009.12 to 2012.12,204 cases of low pulmonary function patients with gastric cancer who were more than 60 years old were selected. After they were carried out the effective preoperative pulmonary function training, all the patients have reached the clinical operation index. Then they were randomly divided into three cavity feeding tube surgery group （ group A,100 cases） and common stomach tube surgery group （group B, 104 cases） according to the settlement way of gastric tube. Intraoperative and postoperative condition and clinical effect of 2 groups were observed. Results Both groups were performed the radical operation successfully without perioperative deaths and anastomotic leakage. There was no significant difference of intraoperative bleeding and operation time between 2 groups（ P 〉 0.05 ）. The anal exhaust time, defecation time and hospitali- zation time of group A were shorter than those of group B, and the incidence of arrhythmia, pulmonary complications of group A were lower than those of group B, the differences were statistically significant （ P 〈 0.05 ）. Conclusion The three cavity feed- ing tube can reduce the incidence of some complications ,shorten hospitalization time in the treatment of elderly low pulmonary function patients with gastric cancer through perioperative careful treatment and nursing care.