Rogers Simon N, Thomson Richard, O'Toole Paul, Lowe Derek
Regional Maxillofacial Unit, University Hospital Aintree, Lower Lane, Liverpool, Merseyside L9 7AL, United Kingdom.
Oral Oncol. 2007 May;43(5):499-507. doi: 10.1016/j.oraloncology.2006.05.002. Epub 2006 Sep 25.
Percutaneous endoscopic gastrostomy feeding (PEG) has an important role in providing nutritional support in selected patients undergoing treatment for oral and oropharyngeal cancer. Although morbidity data have been published there is very little from the patient perspective. The aim of this project was to devise, pilot and survey a PEG specific questionnaire and relate outcomes to health-related quality of life. A cross-sectional survey was conducted in April 2005 of patients who were alive and disease free and treated by primary surgery for oral and oropharyngeal squamous cell carcinoma between 1992 and June 2004. The survey comprised the University of Washington Quality of Life questionnaire and a 24 item PEG questionnaire. Of 344 alive and disease free patients, 243 (71%) responded. Clinical characteristics of responders and non responders were similar. Mean age of responders was 65 (SD 12) and 59% were male. There were 193 (79%) patients who never had a PEG as part of their treatment, 30 (12%) who had their PEG removed (median 7 months), and 20 (8%) who still had a PEG (median 34 months). Patients with PEGs reported significant deficits in all UW-QOL domains compared to non-PEG or PEG-removed patients and also reported a much poorer quality of life. The major PEG related problems were not those of discomfort, leakage or blockage, but interference with family life, intimate relationships, social activities, and hobbies. More can be done to counsel and support patients with long-term PEG placement.
经皮内镜下胃造口术喂养（PEG）在为接受口腔和口咽癌治疗的特定患者提供营养支持方面发挥着重要作用。尽管已经公布了相关发病率数据，但从患者角度来看的却很少。本项目的目的是设计、试行并调查一份针对PEG的问卷，并将结果与健康相关生活质量相关联。2005年4月对1992年至2004年6月间接受口腔和口咽鳞状细胞癌一期手术治疗且存活且无疾病的患者进行了横断面调查。该调查包括华盛顿大学生活质量问卷和一份24项的PEG问卷。在344名存活且无疾病的患者中，243名（71%）做出了回应。回应者和未回应者的临床特征相似。回应者的平均年龄为65岁（标准差12），男性占59%。有193名（79%）患者在治疗过程中从未进行过PEG，30名（12%）患者的PEG已拔除（中位数为7个月），20名（8%）患者仍保留PEG（中位数为34个月）。与未使用PEG或已拔除PEG的患者相比，使用PEG的患者在所有华盛顿大学生活质量领域均报告有显著缺陷，且生活质量也差得多。与PEG相关的主要问题并非不适、渗漏或堵塞，而是对家庭生活、亲密关系、社交活动和爱好的干扰。对于长期留置PEG的患者，可以在咨询和支持方面做得更多。
