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目的比较经皮内镜下胃/空肠造瘘术(PEG/PEJ)和鼻-空肠管(NT)置管在晚期上消化道恶性肿瘤患者家庭肠内营养(HEN)支持中的应用。方法选取2013年1月至2015年6月该院收治的111例接受HEN支持的晚期上消化道恶性肿瘤患者,根据肠内置管途径将其分为PEG/PEJ组(51例)和NT组(60例),比较两种置管方式在HEN中的应用情况、患者并发症发生率、病死率,并进行生存分析。结果 PEG/PEJ组肠内营养相关并发症和管道相关并发症发生率均低于NIT组,差异有统计学意义(P<0.05),而两组病死率比较差异无统计学意义(P>0.05)。出院后6个月累计生存率为43.9%。COX分析显示,肿瘤部位和置管方式是影响患者生存时间的独立因素(P<0.05)。结论 PEG/PEJ较NT置管可降低上消化道恶性肿瘤患者HEN支持的并发症发生率,延长患者生存时间。
Objective To compare the application of percutaneous endoscopic gastro / jejunostomy (PEG / PEJ) and nasojejunal tube (NT) catheterization in home enteral nutrition (HEN) support in patients with advanced upper gastrointestinal cancer. Methods 111 patients with advanced upper gastrointestinal cancer who received HEN support from January 2013 to June 2015 were enrolled in this study. The patients were divided into PEG / PEJ group (n = 51) and NT group (n = 60 cases). The application of two methods of catheterization in HEN, complication rate and mortality of patients were compared, and survival analysis was performed. Results The incidences of complications related to enteral nutrition and complications related to ducts in PEG / PEJ group were significantly lower than those in NIT group (P <0.05), but there was no significant difference in mortality between the two groups (P> 0.05 ). Six months after discharge, the cumulative survival rate was 43.9%. COX analysis showed that tumor location and catheter placement were independent factors influencing survival time (P <0.05). Conclusion PEG / PEJ compared with NT catheter can reduce the incidence of complications of HEN support for patients with upper gastrointestinal cancer, prolonging the survival time of patients.