穿刺式空肠造口术在肝移植中的应用

The use of needle catheter jejunostomy in liver transplantation

目的 :探讨术中穿刺空肠造口在肝移植受体中的应用 ,以便术后早期行肠内营养支持。 方法 :对 5例有适应证的肝移植病人 ,选用Flocare可裂式空肠穿刺造口管 ,于手术结束前 ,在距Treitz韧带约 2 0cm处作穿刺 ,使导管在肠壁内潜行 4～ 5cm后进入肠腔 ,再固定于腹膜壁层上 ,并于术后第 1天经空肠造口管给予肠内营养。 结果 :术中经空肠穿刺 ,放置造口管时间为 (9.2± 2 .3)min ,造口管应用良好 ,分别于术后 1 4～ 4 6天拔除。 5例病人中有 1例发生导管堵塞 ,在介入引导下用导丝予以疏通后重新应用。本组中未发生其他与空肠造口有关的并发症。 结论

Objectives:To evaluate the use of needle catheter jejunostomy for early enteral nutrition in liver transplant recipients . Methods:Five liver transplant recipients who had indication were performed with needle catheter jejunostomy before abdominal wall closure.The Flocare jejunokath was inserted on the small bowel at the point 20 cm distal to the ligament of Treitz,continued to go ahead in the wall of the bowel for a distance of about 4～5 cm,and then pierced into bowel lumen.Enteral nutrition was given through jejunostic tube at postoperative 1st day. Results:The time for placing needle catheter jejunostomy during operation was (9.2±2.3)min.The jejunostic tube was used well and pulled out from 14 to 46 days after operation.One patient occurred with jejunostic tube obstruction, and the tube was reused after treatment.No other complication occurred associated with needle catheter jejunostomy. Conclusions:Needle catheter jejunostomy may become the preferable method for early enteral nutrition in indicated liver transplant recipients.