摘要
目的:上消化道梗阻的患者常常合并营养不良,探讨经内镜下建立肠内营养通路在上消化道梗阻患者中的应用及效果.方法:收集2015年1月至2019年5月我科收治的256例因不同原因导致的上消化道梗阻的患者资料,按肠内营养通路建立的方法分为三组,即A组为经内镜异物钳夹持放置鼻饲管(n=184),B组为经内镜导丝交换法放置鼻饲管(n=29),C组为经皮内镜下胃/空肠造口置管术(n=43).比较三种方法的操作时间、置管成功率、置管相关并发症及置管后并发症的发生率.结果:A组置管时间为(9.12±2.26)min,置管成功率为95.7%(176/184);B组置管时间为(16.12±2.16)min,置管成功率为86.2%(25/29);C组置管时间为(15.87±2.12)min,置管成功率为88.4%(38/43).结论:三种经内镜肠内营养通路建立的方法均安全、可行,成功率高,前两种方法适合于短期内需要接受肠内营养治疗的患者,而经皮内镜下胃/空肠造口置管术更适用于需要长期接受肠内营养支持治疗的患者.
Objective:The patients with upper digestive tract obstruction are frequently accompanied by malnutrition.This study is aimed to investigate the method and effect of three different kinds of methods for enteral nutrition support under gastroscope.Methods:From January 2015 to May 2019,two hundred and fifty-six patients with upper digestive tract 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 95.7%(176/184)with an average time of(9.12±2.26)min in the group A.While in the group B,we needed almost(16.12±2.16)min to place the tubes,and the achievement ratio was 86.2%(25/29).In the group C,the time of the operation was about(15.87±2.12)min and the success ratio was 88.4%(38/43).Conclusion:The three kinds of methods for enteral nutrition support under gastroscope were efficiency and easily to success.First two methods were more applicable to the patients who need the enteral nutrition support in a short term,while the PEJ was more suitable for the patients who need the enleral nutrition support in a long term.
作者
刁艳青
汪志明
张娟娟
钱小丽
严薇
朱楠
朱琳
DIAO Yan-qing;WANG Zhi-ming;ZHANG Juan-juan;QIAN Xiao-li;YAN Wei;ZHU Nan;ZHU Lin(Department of General Surgery,General Hospital Eastern Theater Command,Nanjing 210002,Jiangsu,China)
出处
《加速康复外科杂志》
2019年第2期52-55,共4页
JOURNAL OF ENHANCED RECOVERY AFTER SURGERY
关键词
肠内营养通路
内镜
上消化道梗阻
Enteral nutrition support
Gastroscope
Upper digestive tract obstruction
