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目的观察经皮内镜下空肠造口(PEJ)行胃引流以及空肠内营养支持对消化道恶性肿瘤手术后胃排空障碍的治疗效果。方法恶性肿瘤术后发生胃排空障碍患者10例,采用拖出法施行PEJ,术后通过PEJ的胃引流管进行胃内减压,通过PEJ空肠营养管进行肠内营养支持。结果10例PEJ均操作成功,未发生出血、窒息、腹膜炎、瘘等严重并发症,仅发生空肠营养管尖端易位1例次,切口处少量渗液感染1例次,均成功处理。PEJ术后平均(23．1±9．3)d胃动力恢复,可夹闭胃引流管。术后1～2 d均可以通过空肠营养管进行肠内营养,术后平均(6．3±2．8)d摆脱肠外营养支持。术后平均(41．4±10．8)d拔除PEJ管,体重较术前增加(3．5±1．8)kg,恢复经口饮食。结论PEJ既可以进行胃减压,又可以进行空肠营养,可应用于胃排空障碍的治疗。
Objective To observe the effect of percutaneous endoscopic jejunostomy (PEJ) on gastric emptying and jejunal nutritional support on gastric emptying after gastrointestinal cancer surgery. Methods Ten patients with gastric emptying occurred after malignant tumor. The traumatic approach was performed by PEJ. After operation, the stomach was decompressed by the gastric drainage tube of PEJ and enteral nutrition was supported by PEJ jejunal feeding tube. Results 10 cases of PEJ were operated successfully without serious complications such as hemorrhage, asphyxia, peritonitis and fistula. Only one case of jejunal feeding tube tip translocation occurred, and 1 case of minor exudate infection at incision was successfully treated. The average postoperative PEH was (23.1 ± 9.3) d, and the gastric motility was restored, which could occlude the gastric drainage tube. Enteral nutrition was administered through the jejunal feeding tube 1 to 2 days after operation, with an average of 6.3 ± 2.8 days postoperatively out of the parenteral nutrition support. Postoperative average (41.4 ± 10.8) d PEJ tube removed, body weight increased compared with preoperative (3.5 ± 1.8) kg, to restore the oral diet. Conclusion PEJ can both gastric decompression and jejunal nutrition can be applied to the treatment of gastric emptying disorders.