Kanie J, Akatsu H, Suzuki Y, Shimokata H, Iguchi A
Dept. of Internal Medicine, Fukiage Digestive Endoscopy Center, Nagoya, Japan.
Endoscopy. 2002 Jun;34(6):480-2. doi: 10.1055/s-2002-31987.
The present study was carried out in order to elucidate the mechanism of the development of gastric ulcer, one of the serious complications of PEG tube placement.
This retrospective study included 92 patients who underwent gastric endoscopy after PEG tube placement. Gastric ulcers detected at gastroscopy were examined in relation to the length of the protrusion from the PEG tubes intragastric bumper and the use of histamine H 2 -receptor antagonists.
Gastric ulcers were found in nine of the 92 patients, and in all nine the ulcer was found on the posterior wall of the gastric body, where the tip of the PEG tube was attached. Seven of the 21 patients (33.3 %) who had a PEG tube with a long protrusion from the intragastric bumper developed gastric ulcer. By contrast, only two of the 71 patients (2.8 %) who had a PEG tube with a short protrusion developed gastric ulcer. The use of H 2 -blockers had no significant impact on the development of gastric ulcer.
The occurrence of gastric ulcer after PEG placement was attributable to the shape of the PEG tube within the intragastric space, and not to the use of H 2 -blockers, suggesting that appropriate placement of the PEG tube is an important factor in preventing gastric ulcer.
开展本研究以阐明胃溃疡（经皮内镜下胃造口术（PEG）置管的严重并发症之一）的发生机制。
这项回顾性研究纳入了92例行PEG置管后接受胃镜检查的患者。对胃镜检查时发现的胃溃疡与PEG管胃内缓冲垫的突出长度以及组胺H2受体拮抗剂的使用情况进行了研究。
92例患者中有9例发现胃溃疡，且所有9例溃疡均位于胃体后壁，即PEG管尖端附着处。胃内缓冲垫突出较长的21例患者中有7例（33.3%）发生胃溃疡。相比之下，胃内缓冲垫突出较短的71例患者中仅有2例（2.8%）发生胃溃疡。使用H2阻滞剂对胃溃疡的发生没有显著影响。
PEG置管后胃溃疡的发生归因于PEG管在胃内的形状，而非H2阻滞剂的使用，这表明PEG管的恰当放置是预防胃溃疡的一个重要因素。
