Kuo Yuo-Chen, Shlansky-Goldberg Richard D, Mondschein Jeffrey I, Stavropoulos S William, Patel Aalpen A, Solomon Jeffrey A, Soulen Michael C, Kwak Andrew, Itkin Maxim, Chittams Jesse L, Trerotola Scott O
Division of Interventional Radiology, Department of Radiology, University of Pennsylvania Medical Center, 1 Silverstein, 3400 Spruce Street, Philadelphia, PA 19104, USA.
J Vasc Interv Radiol. 2008 Apr;19(4):557-63; quiz 564. doi: 10.1016/j.jvir.2007.09.027.
To compare the tube performance and complication rates of small-bore, large-bore push-type, and large-bore pull-type gastrostomy catheters.
A total of 160 patients (74 men, 86 women; mean age, 66.9 years, range, 22-95 y) underwent percutaneous fluoroscopic gastrostomy placement between January 2004 and March 2006. Choice of catheter was based on the preference of the attending radiologist. Data were collected retrospectively with institutional review board approval. Radiology reports provided information on the catheter, indication for gastrostomy, technical success, and immediate outcome. Chart review provided data on medical history, postprocedural complications, progress to feeding goal, and clinical outcomes. Statistical analysis was performed to compare the three classes of gastrostomy catheters.
All 160 catheters were placed successfully. Patients who received small-bore catheters (14 F; n = 88) had significantly more tube complications (17% vs 5.6%) and were less likely to meet their feeding goal (P = .035) compared with patients with large-bore catheters (20 F; n = 72). No difference was observed in terms of major or minor complications. Large-bore push-type (n = 14) and pull-type catheters (n = 58) were similar in terms of complication rates. Patients who received large-bore push-type catheters achieved their feeding goals in significantly less time than those with large-bore pull-type catheters (average, 3.8 days vs 6.0 days; P = .04).
Patients who received small-bore gastrostomy catheters are significantly more prone to tube dysfunction. Large-bore catheters should be preferentially used, with push-type catheters performing better with regard to the time to achieve feeding goal.
比较小口径、大口径推式和大口径拉式胃造口导管的导管性能及并发症发生率。
2004年1月至2006年3月期间，共有160例患者（74例男性，86例女性；平均年龄66.9岁，范围22 - 95岁）接受了经皮透视下胃造口术置管。导管的选择基于主治放射科医生的偏好。数据经机构审查委员会批准后进行回顾性收集。放射学报告提供了有关导管、胃造口术指征、技术成功率和即时结果的信息。病历审查提供了有关病史、术后并发症、达到喂养目标的进展情况及临床结果的数据。进行统计分析以比较三类胃造口导管。
所有160根导管均成功置入。与接受大口径导管（20F；n = 72）的患者相比，接受小口径导管（14F；n = 88）的患者导管并发症明显更多（17%对5.6%），且达到喂养目标的可能性更小（P = 0.035）。在主要或次要并发症方面未观察到差异。大口径推式导管（n = 14）和拉式导管（n = 58）在并发症发生率方面相似。接受大口径推式导管的患者达到喂养目标的时间明显短于接受大口径拉式导管的患者（平均3.8天对6.0天；P = 0.04）。
接受小口径胃造口导管的患者明显更容易出现导管功能障碍。应优先使用大口径导管，推式导管在达到喂养目标的时间方面表现更好。
