早期肠内营养对手术患者尤其是上消化道手术患者具有十分重要的意义。 早期外科空肠造口是肠内营养的一种 方式,消化道手术患者可在术中接受置管,术后即可早期进行肠内营养。 可以通过开放式手术包括隧道式空肠造口术(Witzel 空肠造口术)、Roux-en-Y 空肠造口术、穿刺针导管空肠造口术(NCJ)等术式以及开放胃进行空肠造口术和腹腔镜下外科空 肠造口技术实现。 食管切除手术患者,由于肠外营养的并发症较多以及不利于术后消化功能恢复,建议术中空肠造口建立肠 内营养治疗途径给予营养治疗。 同样的,腹部手术患者也可以在术中接受空肠造口置管。 而对于胰十二指肠切除患者,相比 于外科空肠造口,鼻肠管更适用。 对于术前已存在严重营养不良,或术后需要放化疗的患者,可通过空肠造口进行家庭肠内 营养,提高患者生活质量。 本文主要从外科空肠造口技术、适应证等方面介绍目前的最新进展。

Early enteral nutrition is very important for surgical patients especially patients with upper gastrointestinal surgery. Early surgical jejunostomy is a form of enteral nutrition. Patients with digestive tract surgery can receive intraoperative catheterization and enteral nutrition can be given early after operation. There are tunnel jejunostomy Witzel jejunostomy Roux-en-Y jejunostomy needle catheter jejunostomy open stomach perform jejunostomy and laparoscopic surgical jejunostomy techniques. For patients undergoing esophagectomy parenteral nutrition has many complications and is not conducive to the recovery of digestive function after operation and it is recommended to establish an enteral nutrition therapy route for intraoperative jejunostomy to give nutrition therapy. Likewise abdominal surgery patients may also receive a jejunostomy tube during the procedure. For patients with pancreaticoduodenectomy a nasoenteric tube is more suitable than a surgical jejunostomy. For patients with severe malnutrition before surgery or who need radiotherapy and chemotherapy after surgery home enteral nutrition can be performed through jejunostomy to improve the quality of life of patients. This review mainly introduces the latest progress from the aspects of surgical jejunostomy technology and indications.