鼻空肠管和空肠造瘘管置入术的疗效对比

李冰; 李鹏; 巩方明; 严永峰; 孙鹏; 贾宝庆

doi:10.3969/j.issn.1000-8179.20141363

鼻空肠管和空肠造瘘管置入术的疗效对比

doi: 10.3969/j.issn.1000-8179.20141363

解放军总医院肿瘤外一科(北京市 100853)

详细信息

作者简介:
李冰副主任医师。专业方向为胃肠道恶性肿瘤的微创手术及综合治疗, 胃肠道恶性肿瘤的肠内、肠外营养支持及治疗。E-mail:libing301301@sina.com

通讯作者:
贾宝庆 baoqingjia@126.com

计量
- 文章访问数: 59
- HTML全文浏览量: 31
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2014-07-20
- 修回日期: 2014-08-21
- 刊出日期: 2020-12-29

Comparative clinical study of nasojejunal and jejunostomy tube implants

Oncology Department, General Hospital of People's Liberation Army, Beijing 100853, China

摘要

摘要: 目的评估鼻空肠管与空肠造瘘管置入术在全胃切除术患者中行肠内营养的效果。方法将86例进展期胃癌患者随机分为两组, A组:43例采用鼻空肠管置入术行肠内营养治疗; B组:43例运用空肠造瘘管置入术进行肠内营养治疗, 比较两组肠内营养疗效及并发症。结果 B组肛门排气时间、排便时间比A组更短(P < 0.05);B组术后营养指标优于A组(P＞0.05);A、B组耐受性差异有统计学意义(P < 0.05);并发症发生率两组不存在明显差异(P＞0.05)。结论对全胃切除术后患者实施空肠造瘘管置入术行肠内营养, 耐受性更好, 放置时间更长, 可以显著改善患者的营养状态。
- 鼻空肠管 /
- 空肠造瘘管 /
- 全胃切除术 /
- 肠内营养
Abstract: Objective To evaluate the intestinal trophic effects and adverse reactions of nasojejunal and jejunostomy tube implants on patients with total gastrectomy. Methods A total of 86 patients with advanced gastric cancer were randomly and equally divided into two groups. Groups A and B received enteral nutrition therapies through nasojejunal and jejunostomy feeding tube implants, respectively. The therapeutic efficacy of the two methods of enteral nutrition therapy and the corresponding adverse reactions observed in the two groups were compared. Results Group B patients demonstrated shorter anal evacuation and defecation times than group A patients, the difference is statistically significant (P < 0.05). Moreover, the bodyweight, total protein, and albumin levels of the patients significantly decreased in both groups after enteral nutrition therapy was administered (P < 0.05). Postoperative nutritive indexes were higher in group B than in group A; however, no significant difference was obtained between the two groups (P > 0.05). Nonetheless, the patients in group B tolerated the treatment well compared with those in group A (P < 0.05). The complication rates of groups A and B were 18.6% and 23.3%, respectively, but this difference was not significant (P > 0.05). Conclusion Patients subjected to total gastrectomy showed higher tolerance to jejunal tube implants for enteral nutrition than to nasojejunal tube implants, indicating that jejunal tube implants can be used to improve the nutritional status of patients.
- nasojejunal tube /
- jejunostomy tube /
- total gastrectomy /
- enteral nutrition

HTML全文

表 1 两组患者肠功能恢复时间比较(x±s)

Table 1. Comparison of the recovery time of intestinal functions between the two groups of patients(x±s)

表 2 两组患者手术前后营养指标变化比较(x±s)

Table 2. Comparison of changes in the nutritional indexes between the two groups of patients before and after surgery(x±s)

参考文献(15)

[1]	王松, 宗林, 闻伟, 等.术中留置鼻空肠营养管效果观察[J].现代中西医结合杂志, 2010, 19(12):1436-1438. doi: 10.3969/j.issn.1008-8849.2010.12.003 Wang S, Zong L, Wen W, et al. Observation on effect of intraoperative indwelling nasointestinal feeding tube[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2010, 19(12): 1436-1438. doi: 10.3969/j.issn.1008-8849.2010.12.003
[2]	张先进, 陈伟焘, 林新峰.肠内营养常用置管方法的评价[J].肠外与肠内营养, 2013, 20 (4):241-244. doi: 10.3969/j.issn.1007-810X.2013.04.015 Zhang XJ, Chen WT, Lin XF. Introduction and evaluation of the commonly used catheter methods of the enteral nutrition[J]. Parenteral & Enteral Nutrition, 2013, 20(4):241-244. doi: 10.3969/j.issn.1007-810X.2013.04.015
[3]	Gur AS, Atahan K, Aladag I, et al. The eficacy of Nutrition Risk Screening-2002(NRS-2002) to decide on the nutritional support in general surgery patients [J].Bratisl Lek Listy, 2009, 110(5): 290-291. http://www.ncbi.nlm.nih.gov/pubmed/19507663
[4]	章丽, 余丹, 王熙.留置鼻空肠营养管行肠内营养的临床应用分析[J].实用临床医药杂志, 2012, 16(15):60-61, 64. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=jslcyxzz201215019 Zhang L, Yu D, Wang X. Clinical application of lien nasojejunal feeding tube for enteral nutrition[J]. Joural of Clinical Medicine in Practice, 2012, 16(15):60-61, 64. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=jslcyxzz201215019
[5]	王福新.全胃切除术后经留置鼻空肠营养管与空肠造口行肠内营养的临床对比研究[J].中国现代医学杂志, 2011, 21(22):2774-2776. doi: 10.3969/j.issn.1005-8982.2011.22.023 Wang FX. The clinical study of indwelling nasointestinal feeding tube and enteral nutritional by jejunostomy after total gastrectomy [J].China Journal of Modern Medicine, 2011, 21(22):2774-2776. doi: 10.3969/j.issn.1005-8982.2011.22.023
[6]	Mazaki T1, Ebisawa K. Enteral versus parenteral nutrition after gastrointestinal surgery: a systematic review and meta analysis of randomized controlled trials in the English literature[J]. J Gastrointest Surg, 2008, 12(4):739- 755. doi: 10.1007/s11605-007-0362-1
[7]	Gunerhan Y, Koksal N, Sahin UY, et al. Effect of preoperative immunonutrition and other nutrition models oncellular immune parameters[J]. World J Gastroenlerol, 2009, 15(4):467-472. doi: 10.3748/wjg.15.467
[8]	王静松, 陈余, 吕冬梅.全胃切除术患者经留置鼻空肠营养管与空肠造口行肠内营养的临床比较研究[J].医药论坛杂志, 2011, 32(19):28-30. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=hnyyxx201119010 Wang JS, Chen Y, Lu DM. Dong-mei.Clinical comparative study of enteral nutrition by indwelling nasogastric feeding tube and stoma of jejunum in patients with total gastrectomy[J]. Journal of Medical Forum, 2011, 32(19):28-30. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=hnyyxx201119010
[9]	Huang J, Zhou H, Mahavadi S, et al. Signaling pathways mediating gastrointestinal smooth muscle contraction and MLC20 phosphorylation by motilin receptors[J]. Am J Physiol Gastrointest Liver Physiol, 2005, 288(1):23-31. doi: 10.1152/ajpgi.00305.2004
[10]	Dominioni L, Rovera F, Pericelli A, et al. The rational of early enteral nutrition[J]. Acta Biomed Ateneo Parmense, 2003, 74(S2): 41-44. http://cn.bing.com/academic/profile?id=33ffaf63fe558d3182e48881aa6d757f&encoded=0&v=paper_preview&mkt=zh-cn
[11]	姬社青, 马飞, 张斌, 等.空肠造瘘管肠内营养在胃癌患者辅助化疗中的应用[J].河南医学研究, 2014, 23(3):10-12. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=hnyxyj201403004 Ji SQ, Ma F, Zhang B, et al. Enteral nutrition via jejunostomy catheter in gastric cancer patients undergone adjuvant chemotherapy[J]. He-nan Medical Research, 2014, 23(3):10-12. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=hnyxyj201403004
[12]	Aaldriks A, van der Geest LG, Giltay E J, et al. Frailty and malnutrition predictive of mortality risk in older patients with advanced colorectal cancer receivi"g chemotherapy[J]. Geriatr Oncol, 2013, 4 (3):218-226. doi: 10.1016/j.jgo.2013.04.001
[13]	Aoyama T, Yoshikawa T, shirai J, et al. Body weight lossaner surgery is an independent risk factor for continuation of S-l adjuvant chemotherapy for gastric cancer[J]. Ann surg Oncol, 2013, 20(6): 2000-2006. doi: 10.1245/s10434-012-2776-6
[14]	Li Qw, Li GC, Wang YN, et al. Association of nutrition with treatment compliance and toxicities in patients undergoing chemoradiation after gastrectomy[J]. zhonghua wei chang wai Ke za zhi, 2013, 16(6):529-533. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zgwcwkzz201306009
[15]	Stephen JL, Henning KA, Steve T. Early Enteral Nutrition Within 24h of Intestinal Surgery Versus Later Commencement of Feeding: A Systematic review and Meta-analysis[J]. Zhonghua Wei Chang Wai Ke Za Zhi, 2009(13):569-575.