内镜下胃造瘘术胃肠内营养支持对改善危重患者营养状况的价值

The value of percutaneous endoscopic gastrostomy in improving gastrointestinal nutritional status in critically ill patients

目的分析内镜下胃造瘘术(PEG)胃肠内营养支持对改善危重患者营养状况的效果。方法纳入我院2011年1月至2016年6月收治的60例危重症患者作为研究对象,随机分为研究组与对照组,各30例。研究组患者给予PEG胃肠内营养支持,对照组患者给予鼻胃管鼻饲胃肠内营养支持,比较两组治疗后的临床效果。结果两组治疗前各项营养指标(BMI、白细胞、血红蛋白、血清前白蛋白、白蛋白及淋巴细胞计数)及各项免疫指标(CD3+、CD4+、CD8+)比较无显著性差异(P>0.05);治疗后,两组各项营养指标及各项免疫指标较治疗前均有明显改善,而研究组各项营养指标及各项免疫指标改善情况均优于对照组(P<0.05)。研究组术后并发症发生率为13.33%,显著低于对照组的36.67%(P<0.05)。结论对危重症患者采取PEG胃肠内营养支持效果优于鼻胃管鼻饲肠内营养支持,可满足患者各方面营养需求,有利于提升机体免疫力,且术后并发症少。

Objective To analyze the effect of percutaneous endoscopic gastrostomy （PEG） ongastrointestinal nutritional support in improving the nutritional status of critically ill patients. Methods Sixty patients with critically ill were enrolled in our hospital from January 2011 to June 2016. The patients were divided into study group and control group （30 cases each） according to the random number table method. The study group was given gastrointestinal nutrition support by means of PEG. The control group was given gastrointestinal nutrition support by means of nasogastric intubation. The clinical effect of the two groups was compared. Results Before treatment, there were no significant differences in the nutritional indexes （BMI, white blood cells, hemoglobin, serum prealbumin, albumin and lymphocyte count） and immune parameters （CD3＋, CD4＋, CD8＋） between the two groups （P 〉 0.05）. After treatment, the nutritional indexes and the immune indexes of the two groups were significantly improved compared with those before treatment, while the nutritional indexes and the improvement of the immune indexes in the study group were better than those in the control group （P 〈0.05）. The incidence of postoperative complications in the study group was 13.33% which was significantly lower than 36.67% in the control group. Conclusion The effect of gastrointestinal nutrition support by PEG in critically ill patients is better than nasogastric tube feeding.