胃癌伴梗阻病人三种经内镜肠内营养通路建立方法的比较  

Comparison of the efficiency of three kinds of methods for enteral nutrition support under gastroscope in the patients of gastric cancer with obstruction

作　　者：刁艳青[1] 汪志明[1] 王金晶[1] 万晓[1] 钱小丽[1] 李国立[1] 江志伟[1] 

机构地区：[1]南京军区南京总医院解放军普通外科研究所,江苏南京210002

出　　处：《肠外与肠内营养》2016年第2期107-109,共3页Parenteral & Enteral Nutrition

摘　　要：目的:探讨胃癌伴梗阻病人三种经内镜肠内营养(EN)通路建立的方法和效果,为胃癌伴梗阻的病人提供营养支持。方法:将71例胃癌伴梗阻的病人按EN通路建立方法分为A组(经内镜异物钳夹持放置鼻饲管,n=39)、B组(经内镜导丝交换法放置鼻饲管,n=18)和C组[经皮经内镜下胃造口/空肠置管术(PEJ),(n=14)]。比较三种置管方法的操作时间、成功率、相关并发症和置管后并发症的发生率。结果:本组有67例病人成功经内镜建立EN通路,操作过程中无一例出现置管相关并发症。A组置管时间为(10.68±3.15)min,置管成功率为94.9%(37/39);B组置管时间为(15.88±3.74)min,置管成功率为94.4%(17/18);C组置管时间为(16.07±3.4)min,置管成功率为92.8%(13/14)。结论:三种经内镜EN通路建立的方法均安全、可行,成功率高。前两种方法适合于围手术期需要接受EN治疗的病人,而PEJ更适用于晚期胃癌病人的EN支持治疗。Objective： The patients of gastric cancer with obstruction are frequently accompanied by malnutrition. This study is aimed to investigate the effect of three different kinds of methods for enteral nutrition support under gastroscope. Methods： From October 2010 to August 2015,Seventy-one patients of gastric cancer with obstruction were classified into three groups. In the group A,patients were placed the nasal feeding tube with a foreign body forceps under gastroscope. In the group B,patients were placed the nasal feeding tube with guidewire exchange method under gastroscope. In the group C,the patients received percutaneous endoscopic gastrojejunostomy. The time of operation,achievement ratio,complication of the procedure were compared. Results： Tubes were successfully placed in 94. 9%（ 37 /39） with an average time of（ 10. 68 ± 3. 15） min in the group A. While in the group B,we needed almost（ 15. 88 ± 3. 74） min to place the tubes,and the achievement ratio was 94. 4%（ 17 /18）. In the group C,the time of the operation was about（ 16. 07 ± 3. 4） min and the success ratio was 92. 8%（ 13 /14）. Conclusion： The three kinds of methods for enteral nutrition support under gastroscope are effective and easy. First two methods were more applicable to the patients who need the enteral nutrition support before the surgery. The PEJ is more suitable for the patients with advanced gastric cancer.

关 键 词：肠内营养通路 胃镜 胃癌伴梗阻 

分 类 号：R735.2[医药卫生—肿瘤]