Ivor-Lewis食管癌术中营养管顺行置入的应用效果
|
摘要
目的探讨Ivor-Lewis食管癌术中营养管顺行置法的应用效果。方法收集本院心胸外科Ivor-Lewis食管癌手术患者68例,将营养管顺行置入的35例作为观察组,空肠造瘘的33例作为对照组,对比2组应用效果。结果与对照组相比,观察组术中置管时间较短,术后恢复排气时间较早,差异有统计学意义(P <0. 05); 2组术后吻合口瘘及肺部感染、心律失常、肠梗阻方面差异无统计学意义(P> 0. 05);观察组舒适评分高于对照组(P <0. 05)。结论 Ivor-Lewis食管癌手术营养管顺行置入法安全、有效,不影响患者出院后生活,更易为患者接受。
Objective To explore the effect of nutrient tube anterograde catheterization during Ivor-Lewis esophagus cancer operation. Methods A total of 68 cases with Ivor-Lewis esophageal cancer were included in the study,among whom 35 cases with nutrient tube anterograde placement were as observation group,and 33 cases with jejunostomy were as control group. Results Compared with control group,observation group had shorter catheterization time during operation and earlier recovery of exhaust after operation( P < 0. 05); there were no significant differences in postoperative anastomotic leakage,pulmonary infection,arrhythmia,intestinal obstruction; observation group had higher comfort scores than control group( P < 0. 05). Conclusion nutrition tube anterograde placement during Ivor-Lewis esophageal cancer surgery is a safe,and effective method,and it is more acceptable to patients.
Objective To explore the effect of nutrient tube anterograde catheterization during Ivor-Lewis esophagus cancer operation. Methods A total of 68 cases with Ivor-Lewis esophageal cancer were included in the study,among whom 35 cases with nutrient tube anterograde placement were as observation group,and 33 cases with jejunostomy were as control group. Results Compared with control group,observation group had shorter catheterization time during operation and earlier recovery of exhaust after operation( P < 0. 05); there were no significant differences in postoperative anastomotic leakage,pulmonary infection,arrhythmia,intestinal obstruction; observation group had higher comfort scores than control group( P < 0. 05). Conclusion nutrition tube anterograde placement during Ivor-Lewis esophageal cancer surgery is a safe,and effective method,and it is more acceptable to patients.
引文
[1]Bozzetti F,Mariani L,Vullo S L,et al.The nutritional risk in oncology:a study of 1 453 cancer outpatients[J].Supportive Care in Cancer,2012,20(8):1919-1928.
[2]Mullen J T,Davenport D L,Hutter M M,et al.Impact of Body Mass Index on Perioperative Outcomes in Patients Undergoing Major Intra-abdominal Cancer Surgery[J].Annals of Surgical Oncology,2008,15(8):2164-2169.
[3]吕家华,李涛,谢丛华,等.食管癌放疗患者肠内营养专家共识[J].肿瘤代谢与营养电子杂志,2015(4):29-32.
[4]祝倩,高业霞.十二指肠营养管在食管癌手术后的早期应用及护理[J].蚌埠医学院学报,2011,36(8):896-897.
[5]李爽,王立伟,胡文滕,等.早期肠内营养和肠外营养治疗食管癌术后患者临床疗效的Meta分析[J].中国循证医学杂志,2016,16(10):1176-1182.
[6]关志宇,张军,王硕,等.十二指肠营养管在食管癌患者术后肠内营养治疗中的应用[J].肿瘤代谢与营养电子杂志,2017,4(2):194-197.
[7]温静.食管癌患者营养状况与治疗相关性的研究进展[J].肿瘤预防与治疗,2017,30(3):213-218.
[8]沈颖,许可敏,邱家学.食道癌术后不同营养支持方式临床效果的Meta分析[J].中国药物经济学,2010(2):11-25.
[9]Choi A H,O'Leary M P,Merchant S J,et al.Complications of Feeding Jejunostomy Tubes in Patients with Gastroesophageal Cancer[J].Journal of Gastrointestinal Surgery Official Journal of the Society for Surgery of the Alimentary Tract,2016,21(2):259-265.
[10]Elshaer M,Gravante G,White J,et al.Routes of early enteral nutrition following oesophagectomy[J].Ann R Coll Surg Engl,2016,98(7):461-467.
[11]张治,袁方良,任斌辉,等.Ivor-Lewis术中逆行置入法与空肠造瘘法置入空肠营养管比较[J].肿瘤代谢与营养电子杂志,2017,4(3):303-306.
[12]Andersson B,Ansari D,Nordén M,et al.Surgical stress response after colorectal resection[J].Int Surg,2013,98(4):292-299.
[13]王文凭,牛中喜,杨玉赏,等.Ivor-Lewis食管癌切除术中闭合式空肠营养管置入临床经验[J].中国肿瘤临床,2014(23):1495-1499.
[14]喻满成,马魏杰,王海涛,等.上消化道重建术后鼻饲与空肠造口置管肠内营养临床效果比较的Meta分析[J].腹部外科,2016,29(1):55-59.
[15]Torres Júnior L G,de Vasconcellos Santos F A,Correia M I.Randomized clinical trial:nasoenteric tube or jejunostomy as a route for nutrition after major upper gastrointestinal operations[J].World J Surg,2014,38(9):2241-2246.
[16]郭淑轶.乙酰半胱氨酸和盐酸氨溴索联合在术后肺部感染治疗中的应用[J].中国实用医药,2014(3):135-136.
[17]孟战备.开喉剑喷雾剂治疗急性咽炎、喉炎、扁桃体炎疗效分析[J].中国继续医学教育,2016,8(22):187-189.
[18]朱丽霞,高凤莉,罗虹辉,等.舒适状况量表的信效度测试研究[J].中国实用护理杂志,2006,23(13):57-59.
[2]Mullen J T,Davenport D L,Hutter M M,et al.Impact of Body Mass Index on Perioperative Outcomes in Patients Undergoing Major Intra-abdominal Cancer Surgery[J].Annals of Surgical Oncology,2008,15(8):2164-2169.
[3]吕家华,李涛,谢丛华,等.食管癌放疗患者肠内营养专家共识[J].肿瘤代谢与营养电子杂志,2015(4):29-32.
[4]祝倩,高业霞.十二指肠营养管在食管癌手术后的早期应用及护理[J].蚌埠医学院学报,2011,36(8):896-897.
[5]李爽,王立伟,胡文滕,等.早期肠内营养和肠外营养治疗食管癌术后患者临床疗效的Meta分析[J].中国循证医学杂志,2016,16(10):1176-1182.
[6]关志宇,张军,王硕,等.十二指肠营养管在食管癌患者术后肠内营养治疗中的应用[J].肿瘤代谢与营养电子杂志,2017,4(2):194-197.
[7]温静.食管癌患者营养状况与治疗相关性的研究进展[J].肿瘤预防与治疗,2017,30(3):213-218.
[8]沈颖,许可敏,邱家学.食道癌术后不同营养支持方式临床效果的Meta分析[J].中国药物经济学,2010(2):11-25.
[9]Choi A H,O'Leary M P,Merchant S J,et al.Complications of Feeding Jejunostomy Tubes in Patients with Gastroesophageal Cancer[J].Journal of Gastrointestinal Surgery Official Journal of the Society for Surgery of the Alimentary Tract,2016,21(2):259-265.
[10]Elshaer M,Gravante G,White J,et al.Routes of early enteral nutrition following oesophagectomy[J].Ann R Coll Surg Engl,2016,98(7):461-467.
[11]张治,袁方良,任斌辉,等.Ivor-Lewis术中逆行置入法与空肠造瘘法置入空肠营养管比较[J].肿瘤代谢与营养电子杂志,2017,4(3):303-306.
[12]Andersson B,Ansari D,Nordén M,et al.Surgical stress response after colorectal resection[J].Int Surg,2013,98(4):292-299.
[13]王文凭,牛中喜,杨玉赏,等.Ivor-Lewis食管癌切除术中闭合式空肠营养管置入临床经验[J].中国肿瘤临床,2014(23):1495-1499.
[14]喻满成,马魏杰,王海涛,等.上消化道重建术后鼻饲与空肠造口置管肠内营养临床效果比较的Meta分析[J].腹部外科,2016,29(1):55-59.
[15]Torres Júnior L G,de Vasconcellos Santos F A,Correia M I.Randomized clinical trial:nasoenteric tube or jejunostomy as a route for nutrition after major upper gastrointestinal operations[J].World J Surg,2014,38(9):2241-2246.
[16]郭淑轶.乙酰半胱氨酸和盐酸氨溴索联合在术后肺部感染治疗中的应用[J].中国实用医药,2014(3):135-136.
[17]孟战备.开喉剑喷雾剂治疗急性咽炎、喉炎、扁桃体炎疗效分析[J].中国继续医学教育,2016,8(22):187-189.
[18]朱丽霞,高凤莉,罗虹辉,等.舒适状况量表的信效度测试研究[J].中国实用护理杂志,2006,23(13):57-59.