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目的评估CT引导下经皮胃造瘘术对因食管梗阻不能进食的晚期癌症患者补充营养的安全性、可行性以及术后患者营养与生活质量的改善情况。方法回顾性分析2012年12月至2016年6月本院行CT引导下经皮胃造瘘术治疗的18例伴食管梗阻晚期癌症患者的临床资料,观察患者的手术耐受情况、术后并发症及术前、术后1个月、2个月的营养指标变化,包括体质指数(BMI)、血红蛋白(Hb)、白蛋白、血糖、尿素、肌酐、血Na~+、血K~+、淋巴细胞;采用汉化版SF-36生活质量量表比较术前、术后患者生理机能、心理健康与社会功能的改变。结果所有患者在局麻下手术耐受性好,置管成功率100%;肠内营养后1个月、2个月BMI、Hb、血白蛋白较术前均有明显改善(P<0.05);手术后并发症包括造瘘口处轻度疼痛7例、口周少量脓液3例、吸入性肺炎5例、造瘘管堵塞3例、黑便2例。术后1个月、2个月患者的生理机能、心理健康与社会功能均较术前明显改善(P<0.05)。结论CT引导下经皮胃造瘘术对因食管梗阻不能进食的晚期癌症患者补充营养创伤轻微、耐受性好、成功率高、并发症少,术后患者营养及生活质量改善明显,是一种安全、可行的肠内营养方法。
Objective To evaluate the safety and feasibility of CT-guided percutaneous gastrostomy in patients with advanced cancer who can not eat due to esophageal obstruction and the improvement of nutritional status and quality of life after operation. Methods The clinical data of 18 patients with advanced esophageal obstruction who underwent CT-guided percutaneous gastrostomy in our hospital from December 2012 to June 2016 were retrospectively analyzed. The patient’s surgical tolerance, postoperative complications The changes of nutritional indexes such as BMI, Hb, albumin, blood glucose, urea, creatinine, blood Na ~ +, blood K ~ +, Lymphocytes. The Chinese version of SF-36 quality of life scale was used to compare the changes of physiological function, mental health and social function in preoperative and postoperative patients. Results All patients were well tolerated under local anesthesia and the successful rate of catheterization was 100%. The levels of BMI, Hb, and albumin in 1 month and 2 months after enteral nutrition were significantly improved (P <0.05) Postoperative complications included mild pain in the stoma at 7 cases, small amount of pus in the mouth 3 cases, inhalation pneumonia 5 cases, fistula occlusion 3 cases and melena 2 cases. The physiological function, mental health and social function of patients at 1 month and 2 months after operation were significantly improved compared with that before operation (P <0.05). Conclusion CT-guided percutaneous gastrostomy for patients with advanced cancer who can not eat esophageal obstruction due to minor nutritional trauma, good tolerance, high success rate, fewer complications, patients with postoperative nutritional and quality of life improved significantly, is a A safe and feasible method of enteral nutrition.