Kadakia S C, Sullivan H O, Starnes E
Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas 78234-6200.
Am J Surg. 1992 Aug;164(2):114-8. doi: 10.1016/s0002-9610(05)80367-8.
Percutaneous endoscopic gastrostomy (PEG) and percutaneous endoscopic jejunostomy (PEJ) are well-accepted procedures for long-term enteral alimentation. PEG has replaced surgical gastrostomy at many institutions because of its safety and ease. This study was undertaken to evaluate the indications for PEG and PEJ, as well as their success rates, complications with special attention to aspiration, and long-term follow-up. We were specifically interested in reviewing the problem of aspiration in patients with PEG and PEJ. A retrospective review of 79 patients at Brooke Army Medical Center over a 3-year period was done. PEG or PEJ was successful in 79 of 81 patients (97%). The most common indications were neurologic disorders in 46 patients (58%) and cancer in 20 (25.3%). Complications other than aspiration occurred in 11 patients (14%). Aspiration occurred in nine patients after PEG or PEJ (11.4%); six patients had experienced aspiration prior to PEG or PEJ. Six patients had a jejunostomy tube placed through the PEG for prevention of aspiration, and three died of continued aspiration. We conclude that aspiration is not prevented by PEJ, continues to be a major problem after PEJ, and becomes manifest for the first time after PEG.
经皮内镜下胃造口术（PEG）和经皮内镜下空肠造口术（PEJ）是长期肠内营养常用的方法。由于PEG的安全性和简便性，在许多机构中它已取代了外科胃造口术。本研究旨在评估PEG和PEJ的适应证、成功率、并发症，尤其关注误吸情况以及长期随访结果。我们特别关注PEG和PEJ患者的误吸问题。对布鲁克陆军医疗中心3年内的79例患者进行了回顾性研究。81例患者中有79例（97%）PEG或PEJ手术成功。最常见的适应证是46例（58%）神经疾病和20例（25.3%）癌症。除误吸外，11例患者（14%）出现其他并发症。9例患者在PEG或PEJ术后发生误吸（11.4%）；6例患者在PEG或PEJ术前就有过误吸。6例患者通过PEG放置了空肠造口管以预防误吸，3例患者因持续误吸死亡。我们得出结论，PEJ不能预防误吸，在PEJ术后仍是一个主要问题，并且在PEG术后首次出现。
