[1]陈善炜,杜国平.多功能胃肠管在上消化道内镜黏膜下剥离术后的应用[J].医学信息,2021,34(22):40-44.[doi:10.3969/j.issn.1006-1959.2021.22.011]
　CHEN Shan-wei,DU Guo-ping.Application of Multifunctional Gastrointestinal Tube After Upper Gastrointestinal Endoscopic Submucosal Dissection[J].Medical Information,2021,34(22):40-44.[doi:10.3969/j.issn.1006-1959.2021.22.011]
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多功能胃肠管在上消化道内镜黏膜下剥离术后的应用()

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年22期
页码:
40-44
栏目:
论著
出版日期:
2021-11-15

文章信息/Info

Title:
Application of Multifunctional Gastrointestinal Tube After Upper Gastrointestinal Endoscopic Submucosal Dissection
文章编号:
1006-1959（2021）22-0040-05
作者:
陈善炜; 杜国平
（1.广东医科大学研究生学院，广东 湛江 524000；2.南方医科大学顺德医院消化内科，广东 佛山 528300）
Author(s):
CHEN Shan-wei; DU Guo-ping
(1.Graduate School of Guangdong Medical University,Zhanjiang 524000,Guangdong,China;2.Department of Gastroenterology,Shunde Hospital,Southern Medical University,Foshan 528300,Guangdong,China)
关键词:
多功能胃肠管; 内镜黏膜下剥离术; 上消化道; 肠内营养; 免疫功能
Keywords:
Multifunctional gastrointestinal tube; Endoscopic submucosal dissection; Upper digestive tract; Enteral nutrition; Immune function
分类号:
R571
DOI:
10.3969/j.issn.1006-1959.2021.22.011
文献标志码:
A
摘要:
目的 探讨多功能胃肠管在上消化道内镜黏膜下剥离术后的应用价值。方法 收集2013年1月-2020年8月于南方医科大学顺德医院住院，行上消化道内镜黏膜下剥离术的151例患者的临床资料；将其中术后留置多功能胃肠管的81例患者设为观察组，术后留置胃管的70例患者设为对照组。比较两组术后首次开放管饲饮食、置管时间、术后临床症状（咽喉部不适、恶心呕吐、腹痛腹胀）、手术前后血液指标水平、并发症发生情况、住院时间及住院总费用。结果 观察组术后血红蛋白、淋巴细胞、淋巴细胞百分比均高于对照组，白细胞总数、中性粒细胞、中性粒细胞与淋巴细胞比值水平均低于对照组，差异均有统计学意义（P＜0.05）；观察组术后咽喉部不适及恶心、呕吐均低于对照组，差异有统计学意义（P＜0.05）；观察组腹痛、腹胀发生率低于对照组，但差异无统计学意义（P＞0.05）；观察组术后穿孔、发热发生率低于对照组，气腹、气胸发生率高于对照组，但差异均无统计学意义（P＞0.05）；其中1例术后发热伴腹痛，1例术后并发气胸、气腹；对照组2例术后单纯发热，1例术后穿孔、腹膜炎并发热，1例术后出血并发热；两组手术并发症发生率比较，差异无统计学意义（P＞0.05）；观察组术后首次开放管饲饮食时间短于对照组，差异有统计学意义（P＜0.05）；两组术后置管时间、住院时间、住院总费用比较，差异无统计学意义（P＞0.05）。结论 上消化道内镜黏膜下剥离术术后留置多功能胃肠管可以更早地开放管饲饮食，改善患者术后营养状况，减轻炎症反应、降低对患者术后免疫功能的影响，减轻咽喉部不适和恶心、呕吐症状，从而提高患者的耐受性，具有较高应用价值。
Abstract:
Objective To investigate the application value of multifunctional gastrointestinal tube after upper gastrointestinal endoscopic submucosal dissection.Methods The clinical data of 151 patients who underwent endoscopic submucosal dissection of upper digestive tract from January 2013 to August 2020 in Shunde Hospital of Southern Medical University were collected. Among them, 81 patients with postoperative indwelling multifunctional gastrointestinal tube were set as the observation group, and 70 patients with postoperative indwelling gastric tube were set as the control group. The postoperative first open tube feeding diet, catheterization time, postoperative clinical symptoms (throat discomfort, nausea and vomiting, abdominal pain and bloating ), blood index levels before and after surgery, complications, hospital stay and total hospital costs were compared between the two groups.Results The hemoglobin, lymphocyte and lymphocyte percentage in the observation group were higher than those in the control group, and the total number of white blood cells, neutrophils and the ratio of neutrophils to lymphocytes were lower than those in the control group, the differences were statistically significant (P<0.05). The incidences of postoperative throat discomfort, nausea and vomiting in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). The incidence of abdominal pain and abdominal distension in the observation group was lower than that in the control group, but the difference was not statistically significant (P>0.05). The incidences of postoperative perforation and fever in the observation group were lower than those in the control group, and the incidences of pneumoperitoneum and pneumothorax in the observation group were higher than those in the control group, but the differences were not statistically significant (P>0.05), among them, 1 case had postoperative fever with abdominal pain, and 1 case had postoperative pneumothorax and pneumoperitoneum; in the control group, 2 cases had postoperative fever, 1 case had postoperative perforation, peritonitis and fever, 1 case had postoperative bleeding and fever; there was no significant difference in the incidence of surgical complications between the two groups (P>0.05). The first open tube feeding time in the observation group was shorter than that in the control group, and the difference was statistically significant (P<0.05). There was no significant difference in postoperative catheterization time, hospitalization time and total hospitalization cost between the two groups (P>0.05).Conclusion The use of the indwelling multifunctional gastrointestinal tube after the upper gastrointestinal endoscopic submucosal dissection can provide nutritional support through the first tube feeding earlier, improve the postoperative nutritional status of the patient,reduce inflammation, decrease the impact on immune function, mitigate throat discomfort, nausea, and vomiting symptoms and enhance the tolerance in patients, which has considerable value in application.

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更新日期/Last Update: 1900-01-01