Objective To introduce the clinical experience of placing percutaneous endoscopic jejunostomy ( PEJ) tubes in open surgery of elderly patients with radical distal gastreclomy. Methods Totally 60 elderly patients aged above 65 undergoing radical distal gastrectomy in general surgery of Henan tumor hospital from November 2009 to Junary 2010, were randomly divided into two groups; PEJ group in which patients were placed PEJ tubes and the traditional operation group in which patients were placed nasogastric tube and naso-intestinal feeding tube. The differences of the operation time, complication, hospitalization expenses, hospitalization days, scores of SAS and SDS scale and the indexes of immune and nutritional status after the operation and chemotherapy were compared. Results A total of 30 patients of PEJ group were placed the PEJ tube successfully without tube related complication. The operation time, hospitalization expenses and hospitalization days were similar. The scores of SAS and SDS scale between the two groups showed extremely significant difference , the same to the indexes of immune and nutritional status after the operation and chemotherapy. Conclusion Placing PEJ tubes in elderly gastric carcinoma patients in radical distal gastrectomy is a safe and effective method of nourish and decompression. It showed a good tolerability and easy to be cared.%目的 介绍高龄胃癌患者行根治性远端胃切除术中经开腹途径放置经皮内镜下胃造口管的临床使用体会,并与相同例数的传统手术患者进行对比.方法 2009年11月～2010年6月在河南省肿瘤医院普外科60例65岁以上因胃窦癌行根治性远端胃切除术高龄患者,随机分为经腹放置经皮内镜下胃空肠造口管组和传统治疗组,对比两组患者的手术操作时间、术后并发症、住院费用、住院时间、抑郁自评量表和焦虑自评量表评分及术后和辅助化疗后免疫与营养指标的差异.结果 30例患者均在术中开放状态下全麻放置皮内镜下胃空肠造口管,无手术及导管相关并发症发生,未增加手术时间、住院费用及住院时间.两组的抑郁与焦虑量表评分差异均有显著性,术后免疫与营养指标差异亦有显著性.结论 高龄胃癌患者行开放远端胃根治性切除术中放置皮内镜下胃空肠造口管是安全、有效的胃肠减压及肠内营养途径,术后耐受好,易于护理.
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