经皮内镜下胃造口术在重症患者胃肠内营养中的应用.pdfVIP

· 1808· 中国基层医药2007年11月第l4卷第1l期 Chin J Prim Med Pharm．November 2007，voI．14，No．11 经皮内镜下胃造口术在重症患者 胃肠内营养中的应用 林 华 郑瑞强 朱海航 卢年芳 陈齐红 邵 俊 於江泉 【摘要】 目的 探讨经皮内镜下胃造口术在重症患者胃肠内营养中的应用。方法 在胃镜引导下，穿刺 点选择在胃体前壁，给22例重症患者行经皮穿刺胃造口术。结果 所有患者均一次置管成功。术中血压稳 定，sp02均大于97％，操作时间(15、5±2．3)min，出血量(3．8±1．9)ml。术后所有患者均未出现胃瘘、胃结肠 瘘、气腹、反流误吸，吸人性肺炎等严重并发症。结论 经皮下内镜下胃造口术创小，手术时间短，安全性高， 是适合重症患者建立胃肠内营养途径的手术方式。 【关键词】 肠道营养；胃镜检查；胃造口术；危重病 Clinical application of percutaneous endoscopic gastrostomy in gastrointestinal nutrition among critically ill pa- tients LINHua ，ZHENGRui—qiang．ZHUHai—hang．LUNian一 ng，CHENQi—hong，SHAOJun，YUJiang- quan． Intensiz~Care Unit，Subei Hospital ofJiangsu Province Clinical Medical School，Yang．zhou Universi— ty，Yangzhou，Jiangsu 225001，China 【Abstract】 0bjective To explore the clinical application of percutaneous endoscopic gastrostomy in gastroin． testinal nutrition among critically ill patients．Methods Twenty—tWO patients were undertaken percutaneous endo— scopic gastrostomy under the lead of gastroscope．The puncturatio site was located in anterior wall of stomach．Results AIl the procedures were performed successfully for one time．In仃aoperational blood pressure was very steady．At the same time，intra。perational Sp。2 of tile patients all exceeced 97％．The bleeding amount and operation time were respectively(3．8±1．9)ml and(15．5±2．3)min Severe complications such as gastrostoma，gastrocolic fistula， pneumoperitoneum，refluxing or aspiration of gastric juice，inhalant pneumonia didn t occur after the operation．Con- clusion Percutaneous endoscopic gastrostomy was safe and feasible among critically ill patients who needed gastroin— testinal nutrition because of its slight injury，little bleeding and shorter operational time 【Key words】 Enteral nutrition；Gastroscopy；Gastrostomy；Critically illness 传统的肠内营养支持治疗途径有经鼻胃管、经 壁，降低室内亮度，在腹壁上可见胃镜的投照光点。 胃造口和经空肠造口三种，经鼻胃管易引起医院获 局部皮肤消毒铺巾，局部麻醉，