摘要
目的探讨经皮内镜引导下胃造瘘术(PEG)和胃空肠造瘘术(PEJ)肠内营养能否减轻危重症患者的炎症反应。方法术前及术后7和14 d采血,检测血浆清蛋白、血浆内毒素和血浆C-反应蛋白浓度。血浆内毒素检测应用鲎试剂法。术后24 h和第7天经造瘘管注入对比剂观察饲养管是否通畅及造瘘管周围渗漏情况;所有患者随访至拔管或死亡。结果 PEG/PEJ组术后7 d C-反应蛋白和内毒素均有所降低,14 d时下降更明显,术前、术后比较有显著性(P<0.05)。血浆清蛋白术后7和14 d较术前均有升高,且14 d更明显,但无显著性。PEG/PEJ组14 d C-反应蛋白和内毒素与对照组14 d(相同时间抽取血液)比较下降更明显,差异有显著性(P<0.05)。PEG/PEJ组14 d清蛋白水平与对照组14 d(相同时间抽取血液)比较上升更明显,差异有显著性(P<0.05)。结论 PEG/PEJ术是目前较为完善和成熟的微创技术。对于长期无法经口进食的危重症患者,PEG/PEJ肠内营养支持不仅改善患者的营养状况,还可以减轻患者的炎症反应。
[ Objective ] To discuss the effects of enteral nutrition infusion by percutaneous endoscopic gastrostomy/jejunostomy （PEG/PEJ） on levels of serum C-reactive protein, serum endotoxin and serum albumin in patients with severe diseases. [ Methods ] Sixty patients with severe diseases were randomly divided into 2 groups： the PEG/ PEJ group and the control group. The control group accepted the general treatment as well as nutrition infusion by intravenous. The PEG/PEJ group accepted the general treatment as well as nutrition infusion by pereutaneous endo- scopic gastrostomy/jejunostomy. The levels of serum C-reactive protein, serum endotoxin and serum albumin were included as well. [ Results ] The levels of serum C-reactive protein and serum endotoxin in PEG/PEJ group decreased after seven days and significant decreased after fourteen days （P 〈0.05）. The level of serum albumin in PEG/ PEJ group increased after seven and fourteen days, but it is no statistic significant （P 〉0.05）. The levels of serum C-reactive protein, serum endotoxin and serum albumin in PEG/PEJ group were significantly improved compared with the control group （P 〉0.05）. [ Conclusion ] PEG/PEJ is an effective treatment for patients who swallow difficultly. The treatment can improve nutrition status of the patients and inflammation as well.
出处
《中国内镜杂志》
CSCD
北大核心
2013年第10期1041-1044,共4页
China Journal of Endoscopy
