Ⅱ型食管胃结合部腺癌患者全胃切除术后不同空肠营养支持途径的疗效观察

Enteral feeding via nasojejunal approach versus percutaneous endoscopic jejunostomy approach for patients with typeⅡadenocarcinoma of esophagogastric junction after total gastrectomy

  • 摘要: 目的 探索不同空肠营养支持途径在Ⅱ型食管胃结合部腺癌全胃切除术后的临床效果。方法 选取2015年1月1日-2019年1月1日在解放军总医院第六医学中心行全腹腔镜下经腹经膈肌胸腹联合治疗Ⅱ型食管胃结合部腺癌(adenocarcinoma of esophagogastric junction,AEG)的患者84例,按随机数字表法分为两组,每组42例。观察组经皮空肠造口置入营养管,对照组经鼻置入空肠营养管,比较两组置管操作时间、营养状况指标、免疫功能、术后舒适满意度、围术期并发症、随访情况。结果 两组置管操作时间、营养状况指标、免疫功能无统计学差异;观察组术后舒适满意度高于对照组(4.8±0.4 vs 3.6±0.8,P=0.000);观察组术后短期并发症发生率低于对照组(14.2% vs 33.3%,P=0.040)。结论 对于Ⅱ型AEG患者,可优先考虑采用经皮空肠造口置入营养管进行营养支持,有利于患者早日康复。

     

    Abstract: Objective To explore the effect of enteral nutrition via nasojejunal approach versus percutaneous endoscopic jejunostomy approach after surgery in patients with typeⅡadenocarcinoma of esophagogastric junction (AEG). Methods Eighty-four patients who underwent total laparoscopic transabdominal and transdiaphragmatic gastrectomy in the sixth medical center of Chinese PLA General Hospital from January 2015 to January 2019 were selected,and they were randomly divided into percutaneous jejunostomy group (observation group,n=42) and nasojejunal group (control group,n=42).The time of tube placement,nutritional status,immune function,level of postoperative satisfaction,incidence of perioperative complications and following-up of the two groups were compared. Results There was no statistically significant difference in the time of placing tube,nutritional status and immune function between the two groups.The level of postoperative satisfaction of the observation group was significantly higher than that of the control group (4.8±0.4 vs 3.6±0.8,P=0.000).The incidence of short-term postoperative complications of observation group was significantly lower than that of control group (14.2% vs 33.3%,P=0.040). Conclusion For typeⅡAEG patients after surgery,the percutaneous jejunostomy should be used with priority to supply nutrition so that they could recover in short time.

     

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