经皮内镜胃/空肠造瘘术在癌因性肠梗阻患者姑息治疗中的应用价值

Application value of percutaneous endoscopic gastric/jejunum fistula in patients with intestinal obstruction due to carcinoma with palliative treatment

目的探讨经皮内镜胃/空肠造瘘术在癌因性肠梗阻患者姑息治疗中的应用价值。方法 选取河北大学附属医院2010年2月~2015年2月收治的120例癌因性肠梗阻患者为研究对象,采用随机数字表法将其分为对照组（60例）和研究组（60例）,其中对照组行传统经鼻胃肠减压,研究组行经皮内镜下胃/空肠造瘘术姑息治疗。观察比较术前术后营养指标变化、生活质量评分、术后并发症发生率以及生存时间。结果 两组术前总蛋白、白蛋白、转铁蛋白水平比较差异无统计学意义（P〉0.05）,术后均显著升高（P〈0.05）,且研究组显著高于对照组（P〈0.05）。两组患者术前生理健康、心理健康、生理功能、社会功能各个维度评分比较差异无统计学意义（P〉0.05）,术后均显著升高（P〈0.05）,且研究组显著高于对照组（P〈0.05）。研究组并发症发生率为3.33%,显著低于对照组（16.67%）（P〈0.05）。研究组患者生存时间较对照组显著延长（P〈0.05）。结论 经皮内镜胃/空肠造瘘术可以有效改善癌因性肠梗阻患者生活质量和营养状况,降低并发症发生率,在癌因性肠梗阻的治疗中具有良好的应用前景。

Objective To discuss the application value of perculancous endoscopic., gastric/jejunum fistula in patients with intestinal obstruction due to carcinoma With palliative treatment. Methods One hundred and twenty cases of patients with intestinal obstruction due to carcinoma in the Affiliated Hospital of Hebei University from February 2010 to February 2015 were selected as the research subjects and divided into control group （60 cases） and study group （60 cases） according to the random digital table method. The patients in the control group were treated with traditional nasal gastrointestinal decompression, the patients in the study group were given percutaneous endoscopic gastric/jejunum fistula for palliative treatment. The changes of nutritional indexes before and after operation, the scnres of quality of life, the incidence of postoperative complications and survival time were observed and compared. Results There were no significant differences in total protein, albumin, siderophilin levels hefore operation hetween the two groups （P 〉 0.05）, which were significantly improved after operation in the two groups （P 〈 0.05）, and the levels of indexes above in the study group were significantly higher than those in the control group （P 〈 0.05）, There were no significant differences in the scores of physiological health, mental health, physical function and social function betbre operation between the two groups （P 〉 0.05）, and the scores of the two groups were significantly inereased after operation （P 〈 0.05）, and the scores after operation in the study group were significantly higher than those in the control group （P 〈 0.05）. The incidence of complications in the study group was 3.33%, which was significantly lower than that of the con- trol group （16.67%） （P 〈 0.05）, The survival time in the study gruup was significantly longer than that in the eontrol group （P 〈 0.05）. Conclusion Percutaneous endoscopic gastric/jejunum fistula in patients with intestinal ohstruction due to carcinoma can effectively improve the quality of life and nutritional status and reduce the incidence of cormplications, which has good application prospccls on intestinal obstruction due to carcinoma.