经皮内镜下胃造瘘和空肠造瘘术临床应用
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摘要
目的:探讨经皮内镜下胃造瘘(PEG)和经皮内镜下空肠造瘘术(PEJ)的临床应用价值。方法:回顾性分析该院2003年1月至2009年1月进行PEG 33例(其中PEG加PEJ 5例)的临床资料。结果:33例PEG(其中5例PEG加PEJ)均成功完成(成功率100%)。术后3例出现腹部造瘘口皮肤感染,1例出现瘘口少量渗血,1例出现造瘘管蘑菇头滑脱胃壁与腹壁间窦道。所有患者开始注食后营养状况逐渐好转,水电解质平衡得到纠正。术前14例反复发作吸入性肺炎均在抗感染后治愈。结论:PEG及PEJ是一种安全、高效、方便、经济,既符合生理、且人性化的肠内营养方法。由于其操作简便、安全易行、并发症少,值得广泛应用。
Objective: To investigate the feasibility and safety of percutaneous endoscopic gastrostomy(PEG) and percutaneous endoscopic jejunostomy(PEJ).Methods: Clinical date of our hospital was retrospective analyzed from January 2003 to January 2009.Thirty-three patients were treated with PEG,5 of them were treated with PEG plus PEJ.Results: Thirty-three cases of PEG,including five cases of PEG plus PEJ were successfully performed.Three patients had the skin infections of abdominal fistula after PEG.One patient’s fistula had a small amount of bleeding.One patient had buried bumper syndrome.All patients had gradually improved after advancing nutritional support.Fourteen patients of repeated episodes of aspiration pneumonia before the operation were all cured by anti-infection.Conclusion: PEG and PEJ are safe,efficient,convenient,economic,physiological and humane methods of enteral nutrition.
Objective: To investigate the feasibility and safety of percutaneous endoscopic gastrostomy(PEG) and percutaneous endoscopic jejunostomy(PEJ).Methods: Clinical date of our hospital was retrospective analyzed from January 2003 to January 2009.Thirty-three patients were treated with PEG,5 of them were treated with PEG plus PEJ.Results: Thirty-three cases of PEG,including five cases of PEG plus PEJ were successfully performed.Three patients had the skin infections of abdominal fistula after PEG.One patient’s fistula had a small amount of bleeding.One patient had buried bumper syndrome.All patients had gradually improved after advancing nutritional support.Fourteen patients of repeated episodes of aspiration pneumonia before the operation were all cured by anti-infection.Conclusion: PEG and PEJ are safe,efficient,convenient,economic,physiological and humane methods of enteral nutrition.
引文
[1]刘婉薇,廖山婴.经皮穿刺内镜下胃造瘘术临床应用及价值.中国消化内镜,2008,2:9-11.
[2]Gauderer MW,Ponsky JL,Izant RJ Jr.Gastrostomy without laparotomy:a percutaneous endoscopic tech-nique.J Pediatr Surg,1980,15:872-875.
[3]Roche V.Percutaneous endoscopic gastrostomy.Clinical care of PEG tubes in older adults.Geriatrics,2003,58:22-29.
[4]张志军.经皮内镜下胃造瘘术应用进展.国际消化病杂志,2006,26:246-249.
[5]郑丰平,林显艺,梁艳娉,等.经皮内镜下胃造瘘在神经性吞咽障碍患者中的应用.现代消化及介入诊疗,2011,16:245-247.
[6]姚炜,黄永辉,常虹.肌萎缩侧索硬化症患者经皮内镜下胃造瘘术研究.中国医师进修杂志,2011,24:4-6.
[7]欧希龙,刘松桥,邱海波,等.经皮胃镜下胃和小肠造瘘术.中国内镜杂志,2007,13:249-251.
[8]江志伟,黎介寿,李宁.经皮内镜下胃造口术.腹部外科,2005,18:12-14.
[9]Platt MS,Roe DC.Complications following insertion and replacement of percutaneous endoscopic gastrostomy(PEG)tubes.J Forensic Sci,2000,45:822-835.
[10]姚礼庆,钟芸诗,高卫东,等.经皮内镜胃造瘘和小肠造瘘术的临床应用价值.中华胃肠外科杂志,2005,8:413-415.
[11]Anagnostopoulos GK,Kostopoulos P,Arvanitidis DM.Buried bumper syndrome with a fatal outcome,presen-ting early as gastrointestinal bleeding after percutaneous endoscopic gastrostomy placement.J Postgrad Med,2003,49:325-327.
[12]Venu RP,Brown RD,Pastika BJ,et al.The buried bumper syndrome:a simple management approach in two patients.Gastrointest Endosc,2002,56:582-584.
[2]Gauderer MW,Ponsky JL,Izant RJ Jr.Gastrostomy without laparotomy:a percutaneous endoscopic tech-nique.J Pediatr Surg,1980,15:872-875.
[3]Roche V.Percutaneous endoscopic gastrostomy.Clinical care of PEG tubes in older adults.Geriatrics,2003,58:22-29.
[4]张志军.经皮内镜下胃造瘘术应用进展.国际消化病杂志,2006,26:246-249.
[5]郑丰平,林显艺,梁艳娉,等.经皮内镜下胃造瘘在神经性吞咽障碍患者中的应用.现代消化及介入诊疗,2011,16:245-247.
[6]姚炜,黄永辉,常虹.肌萎缩侧索硬化症患者经皮内镜下胃造瘘术研究.中国医师进修杂志,2011,24:4-6.
[7]欧希龙,刘松桥,邱海波,等.经皮胃镜下胃和小肠造瘘术.中国内镜杂志,2007,13:249-251.
[8]江志伟,黎介寿,李宁.经皮内镜下胃造口术.腹部外科,2005,18:12-14.
[9]Platt MS,Roe DC.Complications following insertion and replacement of percutaneous endoscopic gastrostomy(PEG)tubes.J Forensic Sci,2000,45:822-835.
[10]姚礼庆,钟芸诗,高卫东,等.经皮内镜胃造瘘和小肠造瘘术的临床应用价值.中华胃肠外科杂志,2005,8:413-415.
[11]Anagnostopoulos GK,Kostopoulos P,Arvanitidis DM.Buried bumper syndrome with a fatal outcome,presen-ting early as gastrointestinal bleeding after percutaneous endoscopic gastrostomy placement.J Postgrad Med,2003,49:325-327.
[12]Venu RP,Brown RD,Pastika BJ,et al.The buried bumper syndrome:a simple management approach in two patients.Gastrointest Endosc,2002,56:582-584.