经皮咽造瘘术20例临床分析  

Percutaneous cervical pharyngostomy in surgical treatment of 20 patients with head and neck cancer

作　　者：陈泽辉[1] 卢萌[1] 王承勇[1] 方亦鸿[1] 欧阳奇明[1] 陈伟辉[1] 

机构地区：[1]福建医科大学附属协和医院口腔颌面外科,福建福州350001

出　　处：《中国口腔颌面外科杂志》2013年第6期504-508,共5页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的:探讨经皮咽造瘘术在头颈部肿瘤切除和重建手术后提供肠内营养的临床效果。方法:2012年1月—2012年7月,20例行头颈部手术的患者在我科接受经皮咽造瘘术,由经皮咽造瘘胃管提供肠内营养支持。收集每例患者的相关资料,包括患者信息、诊断、治疗方法、安放胃管时间及出现的并发症,对治疗效果和并发症进行分析。结果:所有患者均能耐受经皮咽造瘘口留置的胃管,无营养不良表现。留置胃管时间最短6 d,最长84 d,平均43.8 d。在随访期内,1例患者的胃管意外脱出,2例患者的造瘘口渗出物较多,1例患者诉说胃管异物感比较明显,1例患者因反流性食管炎于术后第6天拔除胃管,其余患者均未发现明显的并发症。拔管后造瘘口可自行愈合,瘢痕小,不影响美观。结论:经皮咽造瘘术是安全可行的,具有美观、舒适的优点,简便、经济,容易推广,并发症少,是一项值得推荐的肠内营养方法。PURPOSE： To investigate the clinical efficacy of percutaneous cervical pharyngostomy in providing enteral nutrition for patients undergoing head and neck cancer resection and reconstruction. METHODS： From January 2012 to July 2012, percutaneous cervical pharyngostomy was performed in 20 patients treated by head and neck surgery to provide postoperative enteral nutrition in our department. Patient infm^nation, diagnoses, surgical procedures, feeding duration and complications were collected and analyzed. RESULTS： All patients were able to tolerate gastric tube inserted by percutaneous cervical pharyngostomy. No symptoms of malnutrition were observed in any patient. All 20 patients were fed through gastric tube, ranging from a minimum of 6 days and a maximum of 84 days, with an average of 43.8 days. Of the 20 patients, one patient had accidental tube removal during the treatment, two others had more exudates around the fistulas during the course of gastric feeding. One patient complained of foreign body sensation. Another patient had the tube accidently removed 6 days after insertion due to occurrence of reflux esophagitis. No other complications were enc.ouutered. All phaqug^stomy wgu^ds healed in 3-4 days v^itlxout the need for suturing. The ee^ical scarring in all cases was imperceptible except upon close observation and was esthetically acceptable to all patients. CONCLUSIONS： Percutaneous cervical pharyngostomy is safe and feasible. This technique is simple, cost effective, providing the patients with advantages of better esthetical results and less postoperative complications. It is a method of providing enteral nutrition which is worthy of wide application.

关 键 词：经皮咽造瘘术 头颈部肿瘤 肠内营养 

分 类 号：R739.91[医药卫生—肿瘤]