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目的:探讨经皮内镜下胃造口术(PEG)营养通路对口腔颌面部恶性肿瘤综合治疗病人的应用价值。方法:将163例拟行综合治疗的口腔颌面部恶性肿瘤病人分为PEG组(n=77)和鼻饲组(n=86),分别通过PEG和鼻胃管接受同样剂量的营养支持。观察两组病人的情绪、食欲、生活质量以及对置管和治疗的耐受性和依从性变化;比较治疗前后体重、体重指数、体重下降百分比、血清清蛋白和转铁蛋白水平等营养指标变化。结果:PEG组病人对治疗的情绪、食欲和生活质量下降不明显,但耐受性和依从性明显提高。鼻饲组对治疗的情绪低落,食欲和生活质量下降明显,耐受性和依从性差,社会生活受到影响。治疗后两组病人的体重、体重指数以及体重下降百分比均显著下降,但PEG组较鼻饲组下降明显减少。治疗后两组清蛋白、转铁蛋白均显著下降,但PEG组明显高于鼻饲组。结论:口腔颌面部恶性肿瘤综合治疗病人对PEG营养通路的耐受性好,依从性高,早期应用可有效地减少体重下降,改善其营养状况。
Objective: To investigate the value of percutaneous endoscopic gastrostomy (PEG) nutrition pathway in the treatment of oral and maxillofacial malignant tumors. Methods: Totally 163 patients with oral and maxillofacial malignancies were divided into PEG group (n = 77) and nasal feeding group (n = 86), receiving the same dose of nutrition support through PEG and nasogastric tube respectively. The changes in mood, appetite, quality of life and tolerance and adherence to catheter and treatment were observed in both groups. Changes in body weight, body mass index, percentage weight loss, serum albumin and transferrin levels were compared before and after treatment . Results: The emotion, appetite and quality of life of the patients in PEG group were not significantly reduced, but the tolerance and compliance were significantly improved. Nasal feeding group on the treatment of depression, appetite and quality of life decreased significantly, tolerance and compliance is poor, social life is affected. After treatment, body weight, body mass index and weight loss percentage decreased significantly in both groups, but the PEG group decreased significantly compared with nasal feeding group. After treatment, albumin and transferrin decreased significantly in both groups, but PEG group was significantly higher than nasal feeding group. CONCLUSION: Patients with oral and maxillofacial malignancies have good tolerance to PEG nutrition pathway and high compliance. Early application can effectively reduce weight loss and improve their nutritional status.