经鼻饲管回输胃液对腹部术后胃瘫恢复的促进作用

目的研究胃液回输在胃瘫治疗中的作用。方法将37例胃瘫患者分为对照组(n=19)和胃液回输组(n=18)。对照组采用常规禁食、有效持续胃肠减压、静脉输液以保持水、电解质及酸碱平衡等保守治疗;应用甲氧氯普胺、红霉素、西沙必利、多潘立酮等促胃动力药物治疗;介入下将鼻饲管放置于空肠20～30cm处,使用营养泵经鼻饲管进行肠道内营养治疗。胃液回输组除不给予静脉补充电解质外,在对照组治疗基础上进行经鼻饲管定时胃液回输,在鼻饲管上加1个三通,使鼻饲管和胃液引流袋相连,可经鼻饲泵向空肠内输注营养液或胃液。根据患者日常3餐饮食时间将胃液以100～150mL·h-1的速度经鼻饲管回输至空肠。对比2组治疗效果。结果 2组治疗后10、20、30d血红蛋白、白蛋白及电解质水平均高于治疗前,差别有统计学意义(P<0.05);胃液回输组治疗后10、20、30d血红蛋白、白蛋白及电解质水平均高于对照组,差别有统计学意义(P<0.05)。胃液回输组患者恢复胃动力时间短于对照组,差别有统计学意义(P<0.05)。结论经鼻饲管回输胃液对胃瘫的恢复有促进作用。

Promotive effect of reinfusion gastric juice throw the nasal feeding tube after abdominal surgery on patients with gastroparesi

Objective Promotive effect of reinfusion gastric juice throw the nasal feeding tube after abdominal surgery on patients with gastroparesi. Methods Thirty-seven patients with gastroparesi were divided into control group( n = 19) and the gastric juice reinfusion group( n = 18) . The control group was given the treatment such as conventional fasting,effective and continuous gastrointestinal decompression,intravenous fluids to maintain water,electrolyte and acid-base balance; Application of metoclopramide,erythromycin,cisapride,domperidone and other prokinetic drugs; Placing nasal feeding tube in the jejunal 20 30 cm throw the intervention,and enteral nutrition therapy was given through nasal feeding tube by nutrition pump. Based on the therapy of the control group,gastric fluid reinfusion group was added a feeding tube with three direct links,so that gastric feeding tube was connected with drainage bag,then nutrition fluid or gastric juice could be given by nasal feeding pump,but the gastric juice reinfusion group wasn't given electrolyte by intravenous drip. The gastric juice was reinfused into jejunum at the speed of 100 150 mL·h -1 according to time of daily three meals. The effects in two groups were observed. Results After the treatment for 10,20 and 30 days,the levels of hemoglobin,albumin and electrolyte in the two groups were higher than pretherapy( P < 0. 05) . After the treatment for 10,20 and 30 days,the levels of hemoglobin,albumin and electrolyte in gastric juice reinfusion group were higher than control group( P < 0. 05) . The gastric power recovery time in gastric juice reinfusion group was shorter than control group( P < 0. 05) . Conclusion Gastric juice reinfusion through nasal feeding tube can promote the recovery of gastroplegia.