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目的:探讨分析内镜下放置空肠营养管的方法和营养支持效果。方法:选择106例需放置空肠营养管的病人随机分为观察组54例和对照组52例。此外,选择同期行鼻胃管肠内营养病人43例作为鼻胃管组。对照组采用传统内镜下经鼻空肠营养管置管术;观察组采用改良后内镜下经鼻空肠营养管置管术;鼻胃管组采取常规鼻胃管肠内营养。比较三组病人手术时间、一次性置管成功率、置管后并发症发生率以及病人置管后营养指标变化情况。结果:观察组和鼻胃管组病人手术时间显著短于对照组(P<0.05),一次性置管成功率显著高于对照组(P<0.05)。三组病人置管后并发症发生率无显著性差异(P>0.05)。三组病人置管后血红蛋白、血清清蛋白以及前清蛋白水平均较治疗前显著改善(P<0.05)。观察组和对照组病人置管前后营养指标比较均无显著性差异(P>0.05),而鼻胃管组病人置管后血红蛋白、血清清蛋白和前清蛋白水平显著低于观察组和对照组(P<0.05)。结论:改良内镜下鼻空肠管置管术能有效缩短置管手术时间,提高一次性置管成功率,降低病人置管手术的痛苦。置管后病人营养支持效果显著。
Objective: To explore the method of endoscopic jejunal feeding tube and the effect of nutritional support. Methods: A total of 106 patients with jejunum feeding tube were randomly divided into observation group (n = 54) and control group (n = 52). In addition, 43 cases of nasogastric tube enteral nutrition were selected as nasogastric tube group. The control group received nasal jejunal nutrition tube placement under traditional endoscopy. The observation group received modified nasal jejunal nutrition tube placement. The nasogastric tube group received conventional nasogastric enteral nutrition. The operation time, the success rate of one-time catheterization, the incidence of complications after catheterization and the changes of nutritional indexes after catheterization were compared between the three groups. Results: The operation time of observation group and nasogastric tube group was significantly shorter than that of control group (P <0.05). Success rate of one-time catheterization was significantly higher than that of control group (P <0.05). The incidence of complications after catheterization in the three groups showed no significant difference (P> 0.05). The levels of hemoglobin, serum albumin and prealbumin in the three groups were significantly improved after treatment (P <0.05). There was no significant difference in the nutritional indexes between the observation group and the control group before and after catheterization (P> 0.05), while the levels of hemoglobin, serum albumin and prealbumin in the nasogastric tube group were significantly lower than those in the observation group and the control group (P <0.05). Conclusion: Modified endoscopic naso-jejunal catheterization can shorten the time of catheterization, improve the success rate of one-time catheterization and reduce the pain of catheterization. After catheterization patient nutrition support effect is remarkable.