Baeten C, Hoefnagels J
Dept. of Surgery, Academic Hospital Maastricht, The Netherlands.
Scand J Gastroenterol Suppl. 1992;194:95-8. doi: 10.3109/00365529209096035.
When a patient needs enteral feeding, there are two methods to administer the nutrition. The method most used is the nasogastric tube (NGT), although in the literature little is published about the advantages and complications of the NGT. The second method is percutaneous endoscopic gastrostomy (PEG). A prospective randomized trial was started, and so far 90 patients have entered the study (46 NGT and 44 PEG). In four patients it was not possible to insert the NGT, and in three patients it was impossible to place the PEG. In both groups 6.5% aspiration was found. Nasal decubitus and swallowing problems were seen in 13% and 17%, respectively, in the NGT group. Intraperitoneal bleeding and abdominal pain were found in 2% and 11%, respectively, in the PEG group. Fixation of the patients was needed in 7% of the PEG and 22% in the NGT group. In eight patients in the NGT group the feeding had to be stopped owing to problems; in none of the PEG group was this necessary. The nursing staff awarded marks to each patient on a scale of 5 for the convenience of care (very good, 1; very bad, 5). This resulted in a mean score of 2.6 in the NGT and 2.0 in the PEG group. The score given by the patients was 2.3 in the NGT and 1.8 in the PEG group. There seems to be a clear preference for the PEG as a method for enteral nutrition.
当患者需要肠内营养时，有两种营养给药方法。最常用的方法是鼻胃管（NGT），不过文献中关于鼻胃管的优势和并发症的报道较少。第二种方法是经皮内镜下胃造口术（PEG）。一项前瞻性随机试验已经启动，到目前为止已有90名患者进入研究（46例使用鼻胃管，44例使用经皮内镜下胃造口术）。有4例患者无法插入鼻胃管，3例患者无法进行经皮内镜下胃造口术。两组均发现6.5%的患者有误吸情况。鼻胃管组分别有13%和17%的患者出现鼻褥疮和吞咽问题。经皮内镜下胃造口术组分别有2%和11%的患者出现腹腔内出血和腹痛。经皮内镜下胃造口术组7%的患者和鼻胃管组22%的患者需要固定。鼻胃管组有8例患者因出现问题而不得不停止喂养；经皮内镜下胃造口术组则无一例需要这样做。护理人员根据护理的便利性对每位患者进行评分（非常好为1分；非常差为5分）。结果鼻胃管组的平均评分为2.6分，经皮内镜下胃造口术组为2.0分。患者给出的评分在鼻胃管组为2.3分，经皮内镜下胃造口术组为1.8分。作为肠内营养的一种方法，经皮内镜下胃造口术似乎明显更受青睐。
