现代医药卫生
現代醫藥衛生
현대의약위생
MODERN MEDICINE HEALTH
2015年
3期
348-350
,共3页
麻醉,全身/方法%内窥镜检查/方法%胃造口术/方法%危重病治疗%病人
痳醉,全身/方法%內窺鏡檢查/方法%胃造口術/方法%危重病治療%病人
마취,전신/방법%내규경검사/방법%위조구술/방법%위중병치료%병인
Anesthesia,general/methods%Endoscopy/methods%Gastrostomy/methods%Gravely ill treatment%Patients
目的：分析经皮内镜Introducer法胃造瘘术在危重患者中的应用价值。方法回顾性分析2009年1月至2013年12月该院96例危重患者实施经皮内镜胃造瘘术的临床资料。其中研究组50例采用Introducer法胃造瘘术，对照组46例采用线拉式法（Pull法）胃造瘘术。比较两组患者耐受性、手术时间、手术前后患者一般指标改变、术后并发症、住院时间等情况。结果两组患者均顺利完成手术，无死亡病例，研究组手术时间低于对照组，差异有统计学意义（P<0.01），两组住院时间比较，差异无统计学意义（P＞0.05）。75%患者术后认为难以忍受Pull法，12%患者认为难以忍受Introducer 法。两组患者手术1个月后血清前清蛋白、清蛋白、血红蛋白较术前均明显提高，差异均有统计学意义（P<0.05）。研究组并发症发生率[4.0%（2/50）]明显低于对照组[30.4%（14/46）]，差异有统计学意义（P<0.01）。研究组可在体外直接更换造瘘管，对照组需胃镜引导下按原造瘘方法更换造瘘管。结论经皮内镜Introducer法胃造瘘术安全、可靠、操作方便。危重患者采用该技术行胃肠内营养更简便、安全，且并发症少。
目的：分析經皮內鏡Introducer法胃造瘺術在危重患者中的應用價值。方法迴顧性分析2009年1月至2013年12月該院96例危重患者實施經皮內鏡胃造瘺術的臨床資料。其中研究組50例採用Introducer法胃造瘺術，對照組46例採用線拉式法（Pull法）胃造瘺術。比較兩組患者耐受性、手術時間、手術前後患者一般指標改變、術後併髮癥、住院時間等情況。結果兩組患者均順利完成手術，無死亡病例，研究組手術時間低于對照組，差異有統計學意義（P<0.01），兩組住院時間比較，差異無統計學意義（P＞0.05）。75%患者術後認為難以忍受Pull法，12%患者認為難以忍受Introducer 法。兩組患者手術1箇月後血清前清蛋白、清蛋白、血紅蛋白較術前均明顯提高，差異均有統計學意義（P<0.05）。研究組併髮癥髮生率[4.0%（2/50）]明顯低于對照組[30.4%（14/46）]，差異有統計學意義（P<0.01）。研究組可在體外直接更換造瘺管，對照組需胃鏡引導下按原造瘺方法更換造瘺管。結論經皮內鏡Introducer法胃造瘺術安全、可靠、操作方便。危重患者採用該技術行胃腸內營養更簡便、安全，且併髮癥少。
목적：분석경피내경Introducer법위조루술재위중환자중적응용개치。방법회고성분석2009년1월지2013년12월해원96례위중환자실시경피내경위조루술적림상자료。기중연구조50례채용Introducer법위조루술，대조조46례채용선랍식법（Pull법）위조루술。비교량조환자내수성、수술시간、수술전후환자일반지표개변、술후병발증、주원시간등정황。결과량조환자균순리완성수술，무사망병례，연구조수술시간저우대조조，차이유통계학의의（P<0.01），량조주원시간비교，차이무통계학의의（P＞0.05）。75%환자술후인위난이인수Pull법，12%환자인위난이인수Introducer 법。량조환자수술1개월후혈청전청단백、청단백、혈홍단백교술전균명현제고，차이균유통계학의의（P<0.05）。연구조병발증발생솔[4.0%（2/50）]명현저우대조조[30.4%（14/46）]，차이유통계학의의（P<0.01）。연구조가재체외직접경환조루관，대조조수위경인도하안원조루방법경환조루관。결론경피내경Introducer법위조루술안전、가고、조작방편。위중환자채용해기술행위장내영양경간편、안전，차병발증소。
Objective To analyze the clinic value of application of percutaneous endoscopic gastrostomy by Introducer in critically﹣illed patients. Methods A retrospective analysis from January 2009 to December 2013 of this hospital was conducted in clinic data of 96 critically﹣illed patients with the percutaneous endoscopic gastrostomy. The observation group (50 cases) was adopted percutaneous endoscopic gastrostomy by Introducer while the control group (46 cases) with percutaneous endoscopic gas﹣trostomy by line pull,The patients′ tolerance,operation time,general indicators change before and after surgery,postoperative complications and the length of time were compared between the two groups. Results The surgery of the two groups were suc﹣cessful, reported no deaths. The operation time in the observation group was shorter than that of the control group ,whose differ ence was statistically significant(P<0.01). Among the patients,75%expressed that it was hard to bear line pull method after the op﹣eration,12% think it was unbearable for Introducer method. The serum prealbumin,hemoglobin,albumin 1 month after the surgery were significantly increased than those of before the surgery. The difference had statistical significance (P<0.05). There was no statistical difference in the length of hospitalization between the two groups (P>0.05). There was no complications in the obser﹣vation group and 10 cases in the control group,including 7 cases colostomy mouth infection,3 cases abdominal infection. The ob﹣servation group was access to direct replacement of fistula in vitro ,while the control group should be operated guided by gastro﹣scope with original colostomy method. Conclusion The percutaneous endoscopic gastrostomy by Introducer is safe ,reliable and convenient,which is suitable for critical patients and the gastrointestinal nutrition is more simple ,safe,and fewer complications.
