摘要：目的 比较重症肿瘤患者幽门后及经胃喂养的临床影响，为重症患者寻求安全、有效的肠内营养途径及置管方法。方法 将需要进行肠内营养的重症肿瘤患者随机分成幽门后及经胃喂养组，胃管置入由护士常规操作，幽门后营养管置入由接受培训的医生或者护士完成。结果 54例重症肿瘤患者纳入研究，幽门后喂养组28例，经胃喂养组26例。床边幽门后置管成功率为70%，置管成功的平均置管时间为（26.96±9.86）分钟。两组基线资料（年龄构成、性别比例、APCHEⅡ评分）未见统计学差异。幽门后喂养组达到目标喂养量的时间（天）较经胃喂养组短（5.39±1.65 vs 7.40±2.88,P<0.05）。ICU住院时间两组未见明显差异（P>0.05）。幽门后喂养组的误吸发生率较经胃喂养组低（3.6% vs 23.6%,P=0.03）。幽门后喂养组管道堵塞发生率较经胃喂养组高（32.1% vs 7.7%, P=0.026）。结论 重症肿瘤患者进行幽门后喂养有利于提高肠内营养的耐受性、降低误吸发生率，CORFLO营养管置管成功率较高，操作简便。

Abstract: Objective To compare the clinical effect of post-pyloric feeding and gastric feeding in critically ill cancer patients and seek safe and effective way of nutrition and catheterization for critically ill patients. Methods The critically ill patients, needing to receive enteral nutrition，were randomly divided into post-pyloric feeding group and gastric feeding group, stomach tube was operated by a nurse following the routine, and the post-pyloric feeding tube was done by trained physicians or nurses. Results 54 cases of critically ill cancer patients were included in the study, 28 cases were in post-pyloric feeding group, 26 cases were in gastric feeding group. Success rate of catheterization in post-pyloric feeding group was 70%, average time of catheterization was 26.96 ± 9.86 minutes. The baseline data (age structure, sex ratio, APCHE II score) of two groups had no statistical difference. Time to reach target feeds in days was shorter in post-pyloric feeding group compared to gastric feeding group (5.39±1.65 vs 7.40±2.88, P<0.05). Incidence of aspiration was lower in post-pyloric feeding group compared to gastric feeding group (3.6% vs 23.6%, P=0.03). Intensive care unit length of stay has no significant difference between the two groups (P>0.05). Incidence of pipeline blockage was higher in post-pyloric feeding group compared to gastric feeding group (32.1% vs 7.7%, P=0.026). Conclusions Post-pyloric feeding for critically ill patients can help to improve tolerance of enteral nutrition and reduce the incidence of aspiration; CORFLO feeding tube is convenient and efficient.