经皮内镜下胃造口术改善口腔颌面部肿瘤综合治疗病人的营养状况  

Supplementation through percutaneous endoscopic gastrostomy improves nutritional status in oral and maxillofacial malignant tumor patients undergoing comprehensive management

作　　者：葛奎[1] 徐兵[1] 张霖[2] 曹大春[3] 朱健[1] 周龙女[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院急诊科,上海200011 [2]上海交通大学医学院附属第九人民医院放疗科,上海200011 [3]上海交通大学医学院附属第九人民医院消化科,上海200011

出　　处：《肠外与肠内营养》2013年第6期345-347,352,共4页Parenteral & Enteral Nutrition

摘　　要：目的:探讨经皮内镜下胃造口术(PEG)营养通路对口腔颌面部恶性肿瘤综合治疗病人的应用价值。方法:将163例拟行综合治疗的口腔颌面部恶性肿瘤病人分为PEG组(n=77)和鼻饲组(n=86),分别通过PEG和鼻胃管接受同样剂量的营养支持。观察两组病人的情绪、食欲、生活质量以及对置管和治疗的耐受性和依从性变化;比较治疗前后体重、体重指数、体重下降百分比、血清清蛋白和转铁蛋白水平等营养指标变化。结果:PEG组病人对治疗的情绪、食欲和生活质量下降不明显,但耐受性和依从性明显提高。鼻饲组对治疗的情绪低落,食欲和生活质量下降明显,耐受性和依从性差,社会生活受到影响。治疗后两组病人的体重、体重指数以及体重下降百分比均显著下降,但PEG组较鼻饲组下降明显减少。治疗后两组清蛋白、转铁蛋白均显著下降,但PEG组明显高于鼻饲组。结论:口腔颌面部恶性肿瘤综合治疗病人对PEG营养通路的耐受性好,依从性高,早期应用可有效地减少体重下降,改善其营养状况。Objective： To evaluate the effects of supplementation through percutaneous endoscopic gastrostomy on oral and maxillofacial malignant tumor patients undergoing comprehensive management. Methods： 163 oral and maxillofacial malignant tumor patients undergoing comprehensive management were divided into two groups： PEG group of 77 cases and nasal feeding group of 86 cases, and were supplemented with same intensity food through percutaneous endoscopic gastrostomy and nasal intubation. Patients＇mood, appetite, life quality, tolerance and compliance were observed during treatment. Changes of body weight, body mass index and percentage of body weight loss were calculated. Nutrition index were also tested before and after treatment respectively. Results： Patients＇mood, appetite and life quality didn＇t decrease after therapy, but tolerance and compliance increased obviously, and social activities were not been affected in PEG group. But in nasal intubation group, data were not optimistic, patients＇mood, appetite and life quality were depressed, their tolerance and compliance were bad, social activities were reduced too. Body weights, percentages of body weight loss and body mass indexes of two groups were decreased, but numbers decreased in PEG group were much less than control group. Although serum album and transferrin of two groups decreased sharply after therapy, those loss in PEG group was much less than those in nasal intubation group. Conclusion： Supplementation through percutaneous endoscopic gastros tomy in oral and maxillofacial malignant tumor patients undergoing comprehensive management can improve patients＇tolerance and compliance, decrease body weight loss effectively and improve the nutrition status.

关 键 词：经皮内镜下胃造口术 口腔颌面部恶性肿瘤 综合治疗 肠内营养 

分 类 号：R739.81[医药卫生—肿瘤]