高龄危重病患者经皮内镜下胃空肠造瘘术营养支持的研究  

Clinical application of percutaneous endoscopic gastrostomy and percutaneous endoscopic jejunostomy in old aged critical patients

作　　者：吴宁[1] 陈雪松[1] 黄方[1] 钱晓明[1] 刘玉亭[1] 

机构地区：[1]南京军区南京总医院老年三科,210002

出　　处：《中华保健医学杂志》2011年第5期364-366,共3页Chinese Journal of Health Care and Medicine

基　　金：南京军区联勤部基金资助项目(08MA089)

摘　　要：目的评价经皮内镜下胃空肠造瘘术(PEG/J),在高龄危重病患者临床治疗中的应用价值。方法选择32例住院高龄患者因疾病无法经口饮食者,采用PEG/J前后自身对照的方法,比较其营养水平、肺部感染的发生率及对胃肠功能的影响。结果 32例患者PEG/J后营养状况均得到改善,术前体质量、血红蛋白、血清白蛋白平均数分别为(47.4±3.2)kg、(86.2±4.0)g/L、(24.6±2.4)g/L,术后3个月明显提高,分别为(55.6±2.5)kg、(102.0±5.4)g/L、(32.6±3.6)g/L,术后与术前比较,差异有统计学意义(P<0.05)。吸入性肺炎的发生次数减少,平均感染时间缩短,胃肠功能恢复。结论 PEG/J可有效改善高龄危重病患者的营养状况,减少肺部感染的发生率,改善胃肠功能,阻止多器官功能障碍的发生;且可在床边操作,值得老年病房推广。Objective To investigate the clinical value of percutaneous endoscopic gastrostomy（PEG）and percutaneous endoscopic jejunostomy（PEJ）in treating elderly critical patients.Methods Thirty-two patients,who couldn＇t drink or eat with mouth in hospitalization,were treated with PEG/J.The level of nutrion,the incidence of pulmonary infection and the effect on gastrointestinal function were compared.Results Three months after PEG/J,the nutritional status of all patients had been improved significantly as the gastrointestinal function recovered.The body mass（47.4±3.2 vs 55.6±2.5）kg,hemoglobin（86.2±4.0 vs 102.0±5.4）g/L,albumin（24.6±2.4 vs 32.6±3.6）g/L were significantly increased（P0.05）.The frequency of aspirated pneumonia decreased,and the average time of infection also shortened.Conclusions PEG/J can effectively improve the nutritional status in elderly severe cases,reduce the incidence of pulmonary infection,help patients recover gastrointestinal function,and prevent the development of multiple organ dysfunction.Furthermore,the operation can be done at bedside,therefore,it is worthy of being spread in elderly ward.

关 键 词：肠内营养 内镜 胃空肠造瘘 高龄 

分 类 号：R151[医药卫生—营养与食品卫生学]