摘要
1982年以来,我们对35例伴明显营养不良的中晚期胃癌病人施行了全胃切除术。8例未采用特殊的营养支持疗法,术后发生食道空肠吻合口痿3例(37％),均死亡;27例经空肠插管早期供给高营养饮食,结果亦发生吻合口瘘3例(11％),均治愈。本文采用较粗的空肠营养管,灌注自制高营养饮食,未见重大不良反应。术后病人体重、Hb及ALB比未用高营养饮食病人恢复为好,能在手术后早期接受化疗。作者对空肠营养的方法、护理、作用及副作用进行了讨论,认为早期空肠营养具有效果明显、经济、安全、简便的优点,适用于营养不良的全胃切除术病人使用。
Since 1982, the author has performed total gastrectomy on thirt y-five patients with gastric cancer. All these cases were not only in a moderately advanced phase but also in a seriously malnutritional state. Out of eight patients without special alimentototherapy, three (37%) died from leakage of esophago jejuhostomy. out of twenty-seven patients with early feeding of high-nourishing diet through a jejunostomy tube, only three (11%) complicated the leakage, furthermore, those all healed up soon by coutinuous feeding, In this study, the author used a relatively thick tube for jejunostomy and irrigated various liquid and semi-liquid diets prepared by ourselves. The results indicated that it didn't cause significantly harmful reaction. The patients who had enteral nutrtion recovered much better in weight, Hb and ALB than those who did not, and could tolerate earlier chemotherapy. The study demonstrates that the early enteral nutrition has many advantages, such as effect, economy, safety and simp-licity. it is especially suitable for those malnourishod patients undergoing total gastrectomy. The manipulation, nursing, mechansim and side-effects of the jejunostomy feeding were also discussed in this article.
关键词
胃肿瘤
全胃切除术
营养疗法
stomach neoplams
total gastrectomy
nutrition diserders
enterral nutrition
