肝移植术后早期空肠造口置管和鼻胃管肠内营养效果的比较  

Comparisons on Effects of Jejunostomy Tube and Nasogastric Tube of Early Enteral Nutrition after Liver Transplantation

作　　者：黄加干[1] 鲍鹤玫[1] 褚静茹[1] 

机构地区：[1]解放军第302医院肝移植中心,北京100039

出　　处：《解放军护理杂志》2012年第18期38-40,共3页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的探讨肝移植受者术后早期肠内营养途径的最佳选择。方法便利抽样法选择2005年5月至2011年10月在解放军第302医院进行肝移植术后需早期肠内营养的85例患者为研究对象,根据肠内营养的方式不同分为空肠造口置管组(n=44)和鼻胃管组(n=41),比较两种肠内营养途径的相关并发症发生情况及治疗结果。结果与鼻胃管组比较,空肠造口置管组术后营养管开始时间提前,差异有统计学意义[(2.45±0.53)d vs(0.75±0.23)d,t=36.34,P<0.01]。空肠造口置管组胃食管反流发生率(9.1%,4/44)低于鼻胃管组(26.8%,11/41),胃潴留发生率(13.6%,6/44)亦低于鼻胃管组(34.3%,14/41),差异均有统计学意义(均P<0.05);而两组患者腹泻、管道堵塞发生率以及急性肾功能不全和急性排异反应的差异无统计学意义(P>0.05)。结论肝移植患者术后进行空肠造口置管能够在术后第1天即进行肠内营养,有效降低胃潴留和胃食管反流发生风险,不增加腹腔感染及肺部感染发生的风险。Objective To explore the optimal pathway of early enteral nutrition after liver transplantation. Methods From May 2005 to October 2011,85 patients undergoing liver transplantation in the hospital were divided into jejunostomy tube group （n=44） and nasogastric tube group （n= 41） by the different enteral nutrition pathways. The results and complications of the two groups were compared. Results Compared with nasogastric tube group, the initial time of enteral nutrition was significantly shortened in jejunostomy tube group I-（2.45±0.53）d vs（0. 75±0.23）d,t=36.34,P;0.01] . The incidence of gastroesophageal reflux was lower in jejunostomy tube group （9. 1%,4/44） than that in nasogastric tube group （26.8% ,11/41） ; the incidence of gastric retention was lower in jejunostomy tube group （13.6% ,6/44） than that in nasogastric tube group （34. 3;, 14/41） （P〈0. 05）. There was no significant difference between the two groups in pulmonary infection,abdominal infection, acute renal failure and acute rejection （P;0.05）. Conclusion Using jejunostomy tube,patients undergoing liver transplantation acomplish day 1 enteral nutrition on the 1st day after surgery,which reduces the risk of gastric retention and gastroesophageal reflux and never increase the risks of intra-abdominal infections and lung infection.

关 键 词：肠内营养 肝移植 鼻胃管 空肠造口术 

分 类 号：R459.3[医药卫生—治疗学]