改良减压组合营养管在晚期胃癌姑息性胃空肠吻合术中的应用  

Analysis of the application of modified combining gastric decompression-nutrition tube in palliative gastrojejunostomy for advanced gastric cancer patients

作　　者：沈志宏[1] 李胜利[2] 王文跃[2] 孟凡强[2] 李启东[2] 许毓敏[2] 陆承[2] 张国超[2] 

机构地区：[1]中国协和医科大学研究生院,北京100730 [2]中日友好医院普外二科,北京100029

出　　处：《中日友好医院学报》2007年第4期210-212,共3页Journal of China-Japan Friendship Hospital

摘　　要：目的:探讨改良减压组合营养管(改良管)在晚期胃癌姑息性胃肠吻合术中的应用价值。方法:采用随机病例对照研究,分析31例手术不可切除且伴幽门梗阻的胃癌晚期患者,均进行了姑息性胃空肠吻合术,13例术中置改良减压组合营养管(实验组),另18例术后置鼻胃管减压(对照组),予以观察其临床疗效及并发症发生情况。结果:实验组与对照组病例平均生存时间6.65±3.63:4.52±2.11个月(P<0.05)。胃瘫的发生率为23.1%:22.2%(P>0.05),胃瘫的康复实验组平均14.33±2.52d,对照组29.75±9.57d(P<0.05)。实验组13例患者对应用改良管均表示满意,对照组仅7例能耐受鼻胃管,另11例表示患者难以忍受鼻胃管带来痛苦(P<0.01)。结论:改良减压组合营养管在姑息性胃肠吻合术后胃瘫的治疗中有效,并能提高晚期胃癌患者的生存期和术后舒适度。Objective：To investigate the value of modified combining gastric decompression-nutrition tube （CGDNT）in palliative gastrojejunostomy for advanced gastic cancer patients.Methods：Random control trail on 31 cases of unresectable gastric cancer patiens,accompanied with pyloric obstruction.Palliative gastrojejunostomy were applied to each case,CGDNT were placed in 13 cases （experimental group）,while in the other 18 cases,nasogastric tube were used for gastric decompression（control group）.Results：Mean survival of the experimental group was 6.65＋3.63 months,and that of the control group was 4.52＋2.11 months,the difference was significant （P〈0.05）.Rate of delayed gastric emptying （DGE）showed no difference between the two groups （23.1% and 22.2% respectively）（P〉0.05）.There were significant differences about the recovering time of DGE. All 13 patients in the experimental group expressed their satisfication of the tube,while 11 patients of the control group complained the pain brougt by the tube was unbearable.Conclusion：The modified CGDNT was effective in the treatment of DGE after palliative gastrojejunostomy in advanced gastric cancer patients,elongate the survival period and improve their quality of life.

关 键 词：幽门梗阻 胃癌 胃瘫 胃造口术 

分 类 号：R735.2[医药卫生—肿瘤]