观察全胃切除术后不同途径肠内营养的疗效

Clinical observation of different enteral nutrition patterns in patients after total gastrectomy

目的：分析胃癌患者全胃切除术后早期肠内营养的方式及临床功效。方法将42例全胃切除术后患者随机分为空肠造瘘置管组（观察组）和经鼻留置空肠营养管组（对照组）,观察两组患者营养状况及不同置管方式对机体的创伤程度,检测导管及术后并发症情况,比较术后下床活动时间、肠道功能恢复时间及住院时间。结果肠内喂养最早始于术后24 h,观察组肠道功能恢复早于对照组（P〈0.05）,且未出现严重消化道症状及导管相关并发症。对照组出现脱管及肠道黏膜溃疡、出血等并发症。结论全胃切除术患者术中放置导管式营养性空肠造瘘是安全有效的营养支持途径,可有效促进胃肠道功能蠕动,减少术后并发症的发生率,有利于患者术后机体功能恢复,改善患者的预后质量,值得临床推广应用。

Objective To analyze the clinical efficacy of different early enteral nutrition patterns on the gastric cancer patients after total gastrectomy. Methods A total of 42 patients after total gastrectomy were randomly divided into the jejunostomy tube group （the observation group） and the nasojejunal tube group （the control group）. The nutrition sta-tus and the degree of trauma were observed, and the postoperative complications were recorded. Then the postoperative ac-tivity time, the recovery time of the bowel function and the duration of hospital stays were compared. Results Enteral nu-trition was conducted in the earliest 48 h after operation. The intestinal function recovery of patients in observation group was earlier than those of the control group （P〈0. 05）, without severe gastrointestinal symptoms or catheter related compli-cations. The off-tube phenomena, intestinal mucosa ulcer and bleeding complications were detected in patients using the nose-intestine tube. Conclusions Jejunostomy tube implanted in the patients during the total gastrectomy is safe and effi-cient for nutrition supports. The approach can promote gastrointestinal peristalsis and reduce the occurrence of postoperative complications. It is beneficial to postoperative functional recovery and the improvement of prognosis, which is worthy of clinical application.