内镜下胃造瘘术在胃肠内营养的临床应用

The Clinical Application of Endoscopic Gastrostomy in the Gastrointestinal Nutrition

目的探讨内镜下胃造瘘术(Percutaneous Endoscopic Gastrostomy,PEG)在胃肠内营养支持的应用价值,改善危重患者营养状况。方法将56例因危重疾病致进食困难、咽麻痹的患者随机分为两组,对照组30例采用鼻饲管鼻饲进行胃肠内营养支持,观察组26例实施PEG胃肠内营养支持,观察两组患者营养改善效果及并发症发生情况。结果观察组术后7 d、14 d血清前白蛋白、白蛋白、血红蛋白、淋巴细胞水平均高于对照组(P<0.05或P<0.01),白细胞低于对照组(P<0.05);观察组7 d、14 d后体质量指数(BMI)为(18.98±1.31)kg/m2、(19.32±1.64)kg/m2,大于对照组的(18.36±1.22)kg/m2、(18.63±1.67)kg/m2(P<0.05);观察组入住ICU时间为(2.76±0.28)d,短于对照组的(3.16±0.43)d(P<0.01);观察组并发症发生率为15.38%,低于对照组的36.67%(P<0.05)。结论 PEG操作简便,患者适应性好,可有效改善患者营养状况,并发症少,值得临床推广治疗。

Objective To investigate the endoscopic gastrostomy（ Percutaneous Endoscopic Gastrostomy,PEG） applications in enteral nutrition support,improve the nutritional status of critically ill patients. The method will cause difficulty eating due to critical illness,pharyngeal paralysis 56 patients were randomly divided into two groups,a control group of 30 patients conducted using nasogastric feeding tube enteral nutritional support,observation group,26 cases of gastrointestinal nutrition support the implementation of the PEG observe two the effect of improving the nutrition of patients and the incidence of complications. Observation group after 7d,14 d prealbumin,albumin,hemoglobin,lymphocyte levels were higher（ P〈 0. 05 or P〈 0. 01）,white blood cells than the control group（ P〈 0. 05）. Observation Group 7 d,14 d after body mass index（ BMI） was（ 18. 98 ± 1. 31） kg /m^2,（ 19.32 ±1.64） kg/m^2,than the control group（ 18.36 ±1.22） kg/m^2,（ 18.63 ±1.67） kg/m2（ P〈 0.05）; observation time of ICU admission group（ 2. 76 ± 0. 28） d,shorter than the control group（ 3. 16 ± 0. 43） d（ P〈 0.01）; observation group complication rate was 15. 38%,lower than the control group 36. 67%（ P〈 0. 05）. Conclusion PEG simple operation,good adaptability to the patient,which can effectively improve the nutritional status of patients,fewer complications,worthy of clinical treatment.