中文摘要：

目的：探讨床旁内镜下无痛胃造瘘空肠置管术在重症急性胰腺炎（SAP）肠内营养中的应用及可行性。方法选取该院2012年9月至2013年5月收治S A P患者共81例，按照随机数字表分为胃造瘘空肠置管组（43例）和鼻空肠置管组（38例），观察两组操作时间、消化道内盘曲率、营养管脱出率等几项指标计算置管成功率；对比两组切口感染率、堵管率以及导管相关肺部感染率等几项指标评估短期治疗效果；计算两组带管时间、舒适度评分以及营养指数等几项指标评估长期治疗效果。结果两组操作时间、消化道内盘区率、营养管脱出率、导管相关肺部感染率、平均留置管时间、舒适度、1个月后营养指数比较，差异有统计学意义（P＜0．05），胃造瘘空肠置管组除操作时间外，均优于鼻空肠置管组；堵管率、切口感染率两组比较，差异无统计学意义（P＞0．05）。结论床旁内镜下无痛胃造瘘空肠置管术成功率高，并发症少，带管时间长，患者易接受，安全性好，操作技术简单可行。

英文摘要：

Objective To observe and compare the operation ,short-term therapeutic effect and long-term therapeutic effect be-tween painless gastrostomy under endoscopy and nasal-jejunal catheterization as well as to explore their clinical feasibility and clini-cal application .Methods 81 cases of patients with severe acute pancreatitis in the hospital ICU from May 2012 to September 2013 , were divided into gastrostomy jejunostomy group（43 cases）and nasojejunal feeding group（38 cases） .The operation time ,gastroin-testinal nutrition tube inner curvature ,removal rateetc were observed to calculate the success rate .Contrast ratio ,plugging rate and catheter related infection rate and several indexes were observed to evaluate the therapeutic effect of two groups of short-term infec-tion ofincision .long-term calculation of two groups with tube ,comfort score and nutritional indexes to evaluate the therapeutic effect index .Results The operation time ,the digestive tract inside area rate ,nutrition tube removal ,catheter related pulmonary infection rate ,average indwelling catheter time ,comfort ,nutrition index of the two groups had statistically significant （P〈0 .05） ,plugging rate ,wound infection rate had no statistically significant （P〉0 .05） .Conclusion With fewer complications and longer tube time , painless gastrostomy under endoscopy is safe ,simple and feasible ,which is easily accepted by patients .