经皮内镜下空肠造口治疗恶性肿瘤术后胃排空障碍  

Percutaneous endoscopic jejunostomy for the management of delayed gastric emptying in postoperative cancer patients

作　　者：江志伟[1] 黎介寿[1] 汪志明[1] 吴素梅[1] 丁凯[1] 黄琦[1] 佴永军[1] 刘碧竹[1] 李强[1] 李宁[1] 

机构地区：[1]南京军区南京总医院全军普通外科研究所,210002

出　　处：《中华普通外科杂志》2006年第6期423-424,430,共3页Chinese Journal of General Surgery

摘　　要：目的观察经皮内镜下空肠造口(PEJ)行胃引流以及空肠内营养支持对消化道恶性肿瘤手术后胃排空障碍的治疗效果。方法恶性肿瘤术后发生胃排空障碍患者10例,采用拖出法施行PEJ,术后通过PEJ的胃引流管进行胃内减压,通过PEJ空肠营养管进行肠内营养支持。结果10例PEJ均操作成功,未发生出血、窒息、腹膜炎、瘘等严重并发症,仅发生空肠营养管尖端易位1例次,切口处少量渗液感染1例次,均成功处理。PEJ术后平均(23．1±9．3)d胃动力恢复,可夹闭胃引流管。术后1～2 d均可以通过空肠营养管进行肠内营养,术后平均(6．3±2．8)d摆脱肠外营养支持。术后平均(41．4±10．8)d拔除PEJ管,体重较术前增加(3．5±1．8)kg,恢复经口饮食。结论PEJ既可以进行胃减压,又可以进行空肠营养,可应用于胃排空障碍的治疗。Objective To report our clinical experience of percutaneous endoscopic jejunostomy （PEJ） for the management of delayed gastric emptying （DGE） in postoperative cancer patients. Methods Ten postoperative cancer patients were transferred to our hospital due to continuous nausea and vomiting, and serious malnutrition caused by delayed gastric emptying. The diagnosis of DGE was confirmed by gastroenterography. All ten patients received PEJ by pull technique for gastric decompression and longterm enteral nutrition. Results Procedures were all successful without serious complication, except for 1 case in which the jejunal tube dislocated to gastric lumen, and another one with abdominal incision infection. Gastric motility recovered after an average （ 23. 1 ± 9. 3 ） d and the gastric tubes were closed. Enteral nutrition begun through jejunal tube after 1 - 2 days, and parenteral nutrition stopped after （6. 3 ± 2. 8） d. PEJs were removed by endoscopy after （41.4 ± 10. 8） d when the patients were on oral diet with an average gain of body weight at （ 3.5 ± 1.8 ） kg. Conclusion PEJ can be used for gastric decompression and enteral nutrition, so it plays a role in the management of DGE.

关 键 词：胃排空 消化系统肿瘤 营养支持 空肠造口术 

分 类 号：R735[医药卫生—肿瘤]