内镜下经皮胃造瘘术对老年患者营养状况及并发症的影响

李莉 甘甜 林艳 李斐 张冬琼 邓敏 黄嫣然 廖晓敏

【摘要】目的觀察内镜下经皮胃造瘘术对60岁以上老年患者营养状况及并发症的影响。方法选取2015年1月至2017年1月收治的无法自主进食的老年患者60例为研究对象，根据随机数字表分为观察组及对照组，各30例。观察组实施内镜下经皮胃造瘘术，对照组实施传统经鼻营养支持。观察并比较两组患者体重指数、营养指标、免疫指标。结果治疗前，两组患者体重指数及营养指标比较，差异无统计学意义（P>0.05），治疗后，观察组体重指数高于对照组，营养指标改善优于对照组，差异有统计学意义（P<0.05或0.01）；治疗前，两组患者免疫指标水平比较，差异无统计学意义（P>0.05），治疗后，观察组各免疫指标水平改善明显优于对照组，差异有统计学意义（P<0.05或001）。结论老年患者实施内镜下经皮胃造瘘术施以营养支持，患者体重指数明显提升，营养状况显著改善，免疫功能提高。

【关键词】老年患者；内镜；经皮胃造瘘术；营养状况

中图分类号：R459.3文献标识码：ADOI：10.3969/j.issn.10031383.2018.02.009

Effects of endoscopic percutaneous gastrostomy on nutritional

status and complications in elderly patients

LI Li，GAN Tian，LIN Yan，LI Fei，ZHANG Dongqiong，

DENG Min，HUANG Yanran，LIAO Xiaomin

（Department of Gastroenterology，Jiangbin Hospital of Guangxi Zhuang Autonomous Region，Nanning 530021，China）

【Abstract】ObjectiveTo observe the effects of percutaneous endoscopic gastrotomy on nutritional status and complications in elderly patients over 60.Methods60 patients who had lost independent feeding ability and been seeking treatment in the hospital between January 2015 and January 2017 were selected as research subject，and then according to the random number table，these patients were divided into observation group and control group，with 30 cases in each group.The observation group received percutaneous endoscopic gastrotomy，whereas the control group received traditional nasal nutrition support.Body mass index，nutritional index，immune index，quality of life and complications were observed and compared between the two groups.ResultsBefore treatment，the comparison of body mass index and nutrition indicators showed no statistically significant difference between the two groups（P>0.05），after treatment，however，the body mass index in the observation group was higher than that in the control group，and the nutritional index was better than that in the control group，the differences were statistically significant （P<0.05 or 0.01）.Before treatment，there was no statistically significant difference in immune indexes between the two groups（P>0.05），after treatment，however，all immune indexes in the observation group were significantly better than those in the control group，the difference was statistically significant （P<0.05 or 0.01）.ConclusionFor elderly patients，percutaneous endoscopic gastrotomy with nutritional support can significantly improve their body mass index，nutritional status and immune function.

【Key words】elderly patients；endoscopy；percutaneous gastrotomy；nutritional status

对于无法正常自行进食，需实施全肠外营养的患者而言，肠内环境紊乱或严重营养不足极易导致肠绒毛减少、肠黏膜萎缩甚至发生肠内溃疡，对患者的机体功能恢复进程产生严重影响[1]。全肠内营养支持是一种经济、安全、近似于生理结构的肠内营养支持方式，在临床上的使用备受医护人员的青睐及认可。以往为患者实施的鼻饲营养支持的方式极易发生误吸，增加患者吸入性肺炎发生风险，具有较高的拔管率，对于需要长期实施肠内营养支持治疗患者而言该种方式并不适用。此外传统的胃造瘘肠内营养实施需要开腹，创伤较大，不符合现代精准医疗模式及微创理念[2]。近……