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营养支持团队对经皮内镜下胃造口术的长期管理。

Long-term management of percutaneous endoscopic gastrostomy by a nutritional support team.

作者信息

Cortez-Pinto H, Correia A Pinto, Camilo M E, Tavares L, De Moura M Carneiro

机构信息

Departamento de Medicina 2, Hospital de Santa Maria, Lisboa, Portugal.

出版信息

Clin Nutr. 2002 Feb;21(1):27-31. doi: 10.1054/clnu.2001.0499.

Abstract

BACKGROUND/AIMS: Percutaneous Endoscopic Gastrostomy (PEG) has become a commonly-performed procedure, to provide enteral nutrition for patients who are unable to eat. The aims of this study were to evaluate the long term efficacy, morbidity and mortality of percutaneous endoscopic gastrostomy (PEG).

MATERIAL AND METHODS

We analysed 144 patients who underwent a PEG procedure. Survival curves were done with the Kaplan-Meier method. The indication was long-term enteral nutrition in patients unable to maintain adequate nutrition by mouth.

RESULTS

The procedure was successful in all but one case. Mean age was 62 (18-85) years, 89 (62%) males. Seven patients recovered from their primary disease and gastrostomy tube was removed. Mean follow-up was 7.3+/-10.8 (1--66) months. Survival rates at 30 days, 1 year and 3 years following gastrostomy were 82%, 36% and 14%, respectively. Survival curves were better in females (P<0.0001). In almost all cases, patients were fed with current home-prepared food, and were ambulatory. There were no differences in survival curves according to the nutritional status.

CONCLUSIONS

There were few procedure-related complications, but a high short-term mortality, probably related with the underlying disease. The use of home-prepared food through the gastrostomy was very well tolerated, and should be encouraged.

摘要

背景/目的:经皮内镜下胃造口术(PEG)已成为一种常用手术,用于为无法进食的患者提供肠内营养。本研究的目的是评估经皮内镜下胃造口术(PEG)的长期疗效、发病率和死亡率。

材料与方法

我们分析了144例行PEG手术的患者。采用Kaplan-Meier法绘制生存曲线。适应证为无法经口维持充足营养的患者的长期肠内营养。

结果

除1例手术外,其余均成功。平均年龄为62(18 - 85)岁,男性89例(62%)。7例患者原发疾病康复,胃造口管拔除。平均随访时间为7.3±10.8(1 - 66)个月。胃造口术后30天、1年和3年的生存率分别为82%、36%和14%。女性的生存曲线更好(P<0.0001)。几乎所有患者均采用现有的家庭自制食物喂养,且可自由活动。根据营养状况,生存曲线无差异。

结论

手术相关并发症较少,但短期死亡率较高,可能与基础疾病有关。通过胃造口使用家庭自制食物耐受性良好,应予以鼓励。

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