摘要
目的:探讨经胃造瘘管放置空肠营养管治疗上消化道穿孔老年患者的可行性及治疗价值.方法:将我院普外科2008-02/2012-07收治的38例消化道穿孔患者,根据其肠内营养方式分为2组,A组患者术后采用鼻饲管进行肠内营养,B组患者采用经胃造瘘放置空肠营养管术后予肠内营养.分析比较两组患者术后出现呼吸道、消化道及其他各类不适的比例.结果:B组患者术后排斥引流管心理、鼻咽部不适、异物感、置管营养期间恶心、呕吐、早起(<3d)下床活动及置管后严重咳嗽、咳痰、合并肺炎等发生率与A组患者比较有明显统计学意义(P=0.036);营养改善方面,两组手术后第9天与第1天比较白蛋白,前白蛋白等指标均明显升高(P=0.024;0.044),但二者第9天之间比较无明显差异(P>0.05).结论:采用经胃造瘘管置空肠营养管,术后早期行肠内营养,患者耐受性好,并发症低,尤其适合老年上消化道穿孔患者.
AIM： To assess the feasibility and therapeutic value of placement of jejunal feeding tubes via a gastrostomy stoma in elderly patients with upper gastrointestinal perforation. METHODS： Thirty-eight elderly patients with upper gastrointestinal perforation treated at our hospital from February 2008 to July 2012 were divided into two groups, those with a nasogastric tube or nasointestinal tube （group A） and those with a jejunal feeding tube placed via a gastrostomy stoma （group B）. The percentages of patients with discomfort in the respiratory tract or gastrointestinal tract and other parameters were compared between the two groups. RESULTS： Group B was significantly different from Group A in the percentages of patients with a fear of intubation or complaints of nasopharyngeal discomfort, serious cough and expectoration, and the incidence of nausea and vomiting during the period of enteral nutrition （all P〈0.05）. Albumin and prealbumin levels on day 9 after surgery were significantly higher than those on day 1 （both P〈0.05）; however, there were no significant differences in albumin and prealbumin levels between the two groups of patients （both P〉0.05）. CONCLUSION： Placement of jejunal feeding tubes via a gastrostomy stoma has advantages of fewer complications and better tolerance and is an optimal method for elderly patients with upper gastrointestinal perforation.
出处
《世界华人消化杂志》
CAS
北大核心
2013年第3期278-281,共4页
World Chinese Journal of Digestology
关键词
老年
上消化道穿孔
肠内营养
胃造瘘术
置管方式
Elderly
Upper gastrointestinal perforation
Enteral nutrition
Gastrostomy
Intubation
