老年胃癌患者术后应用肠内营养管胃肠减压的临床研究  

Clinical significance of postoperative gastrointestinal decompression with enteral feeding tube in elderly patients with gastric cancer

作　　者：宗祥龙[1] 季鑫[1] 贾子豫 吴晓江[1] 张霁[1] 步召德[1] 

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所胃肠外科 恶性肿瘤发病机制及转化研究教育部重点实验室,100142

出　　处：《中华老年医学杂志》2017年第6期680-682,共3页Chinese Journal of Geriatrics

摘　　要：目的探讨老年胃癌患者术后应用肠内营养管胃肠减压的临床效果。方法选取2015年1月～2015年12月在我院手术治疗后予以肠内营养管胃肠减压治疗的78例胃癌患者作为治疗组，同时选取早期手术治疗时实施静脉营养或普通胃管减压治疗的66例胃癌患者作为对照组，比较两组患者胃管畅通率、术后恢复、营养免疫改善、不良反应以及并发症发生率等指标。结果治疗组和对照组患者不良反应发生率[3．0％和12．8％（χ^2=4．4857，P=0．0342）]和并发症发生率[1．5％和10．2％，（χ^2=4．6620，P=0．0308）]，与对照组比较差异具有统计学意义；治疗组患者术后排气[（3．1±0．3）d和（4．0±0．1）d，（t=24．9227，P=0．0000）]和排便时间[（4．3±0．6）d和（5．5±1．1）d，（t=7．9189，P=0．0000）]、术后拔管时间[（5．3±1．3）d和（10．1±2．2）d，t=15．5690，P=0．0000）]、住院时间[（12．3±2．5）d和（18．6±3．2）d，（t=12．9864，P=0．0000）]、术后体重[（57．2±4．9）kg和（49．0±7．2）kg，（t=-7．8408，P=0．0000）]、血浆前蛋白[（133．2±11．2）g／L和（104．5±10．3）g／L，（t=-16．0055，P=0．0000）]、血红蛋白[（4．7±1．0）g／L和（3．2±0．6）g／L，（t=-11．0991，P=0．0000）]以及外周血淋巴细胞计数[（3．5±0．7）×10^9／L和（2．1±0．4）×10^9／L，（t=-15．0088，P=0．0000）]等均显著优于对照组。结论老年胃癌患者术后通过肠内营养胃肠减压与普通胃管减压具有类似效果，但肠内营养治疗患者术后不良反应和并发症更少，营养和免疫指标更佳，术后恢复更快，值得推广应用。Objective To investigate the clinical effects of gastrointestinal decompression with enteral feeding tube in elderly patients with gastric cancer. Methods 78 cases of gastric cancer patients undergoing postoperative gastric decompression with enteral feeding tube were selected as the treatment group, and 66 patients with gastric cancer undergoing postoperative intravenous nutrition and gastric decompression with routine nasogastrie tube as the control group in our hospital from January 2015 to December 2015. The incidence rate of gastric tube patency, faster postoperative recovery,nutritional immune improvement, adverse reaction and complication were compared between the two groups. Results The incidence rate of adverse reactions and complications in treatment group were significant lower than in control group（3.0% vs. 12.8%, χ^2= 4. 4857, P = 0. 0342;1.5 vs. 10.2%,χ^2 = 4. 6620, P = 0. 0308, respectively）. Following parameters were significant better in treatment group versus in control group ： the time of evacuating [（ 3.1 ± 0.3 ） d vs. （4.0 ±0. 1 ） d, t = 24. 9227,P=0. 0000],defecation[（4.3±0.6）d vs. （5.5±1.1）d,t=7. 9189,P=0. 0000], extubation [（5.3±1.3）d vs. （10. 1±2.2）d,t=15. 5690,P=0. 00001,hospitalizationS（12.3±2.5）d vs. （18.6± 3.2）d,t =12.9864,P=0.00001,postoperative bodyweight[（57.2±4.9）kg vs（49.0＋7.2）kg,t=- 7.8408,P=0.00001,plasma protein[（133.2±11.2）g/L vs（104.5±10.3）g/L,t=-16.0055,P=0. 0000],hemoglobinS（4.7±1.0）g/L vs（3.2 ± 0.6）g/L,t= - 11. 0991, P= 0. 00001 and peripheral blood lymphocyte count[（3.5±0.7） × 10^9/L vs（2. 1±20.4） × 10^9/L,t= - 15. 0088,P= 0. 00001. Conclusions Effects of postoperative gastrointestinal decompression in elderly patients with gastric cancer are similar between with routine gastric tube and with enteral feeding tube. However, the enteral feeding tube-induced enteral nutrition shows fewer side effects and complications, better nutritional and immune effects,and faster postoperative rec

关 键 词：肠内营养置管 胃肠减压 临床效果 

分 类 号：R735.2[医药卫生—肿瘤]