胃癌术后胃瘫的影响因素及其空肠营养管的治疗作用  

Risk Factors of Gastroparesis Post-Gastrectomy and Therapeutic Effect of Jejunum Nutrition Tube in Gastric Cancer

作　　者：刘贵长 

机构地区：[1]江西省兴国县人民医院,江西兴国341000

出　　处：《中国医学创新》2014年第36期57-59,共3页Medical Innovation of China

摘　　要：目的:探讨胃癌术后胃瘫的影响因素及其空肠营养管的防治作用。方法:选取本院消化外科住院部胃癌手术患者1604例,其中术后胃瘫62例,采用单因素和Logistic多元回归分析分析胃癌术后胃瘫的影响因素。并根据不同营养支持治疗方式将术后胃瘫患者分为两组,观察组32例采用空肠营养管支持治疗,对照组30例采用肠外营养支持治疗,比较两组患者营养指标和免疫功能指标的差异。结果:年龄、术前幽门梗阻、心理因素、基础疾病、手术时机、术中出血量和进食不当等不同对胃癌术后胃瘫率影响差异显著(P<0.05),其中术后进食不当、术前幽门梗阻和基础疾病是胃癌术后胃瘫的独立危险因素(P<0.05)。观察组营养指标(白蛋白、前白蛋白、转铁蛋白)水平和免疫功能指标(Ig A、Ig M)均明显高于对照组,两组比较差异均有统计学意义(P<0.05)。结论:胃癌术后胃瘫受术后进食不当、术前幽门梗阻和基础疾病等多因素影响,其中空肠营养管支持治疗有助于改善术后胃瘫患者营养和免疫功能状况。Objective：To explore the factors of gastroparesis post-gastrectomy and therapeutic effect of jejunum nutrition tube in gastric cancer.Method：1604 cases of gastric cancer post-gastrectomy were selected, including 62 cases postoperative gastroparesis, univariate and multivariate logistic regression analyzed gastroparesis post-gastrectomy factors. According to different nutritional support treatment gastroparesis patients were divided into two groups, the observation group had 32 cases, were used the jejunum nutrition tube treatment, the control group had 30 cases, were used parenteral nutrition support treatment, nutritional and immune function indexes between groups were compared.Result：Age, preoperative pyloric obstruction, psychological factors, the underlying disease, operation time, bleeding volume and improperly eating difference on gastric cancer postsurgical gastroparesis rate effects differ significantly（P〈0.05）, wherein improperly eating, pyloric obstruction and underlying disease were independent risk factors（P〈0.05）. The nutritional and immune function indexes of the observation group were significantly higher than the control group（P〈0.05）.Conclusion：The factors of eating improperly, pyloric obstruction and basic diseases are gastric cancer postsurgical gastroparesis,and the jejunum nutrition tube treatment contributes to improving postoperative gastroparesis nutrition and immune function.

关 键 词：胃癌 胃瘫 空肠营养管 治疗 

分 类 号：R735.2[医药卫生—肿瘤]