Wang Zhi-Ming, Jiang Zhi-Wei, Diao Yan-Qing, Wu Su-Mei, Ding Kai, Li Ning, Li Jie-Shou
Research Institute of General Surgery, Nanjing General Hospital of PLA, Nanjing Military Command, Nanjing 210002, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2008 Jun;30(3):249-52.
To summarize the clinical experiences in percutaneous endoscopic gastrostomy (PEG)/percutaneous endoscopic jejunostomy (PEJ).
We retrospectively analyzed the clinical data of 578 patients who received either PEG or PEJ from July 2001 to December 2007 in our hospital. The data analyzed included the type, aim, duration, success rate, and complications of these procedures.
Of 578 patients, 247 patients underwent PEG, 293 patients underwent percutaneous endoscopic gastrojejunostomy (PEGJ), 4 patients received percutaneous endoscopic duodenostomy (PED), 4 patients underwent direct percutaneous endoscopic jejunostomy (DPEJ), 4 patients underwent percutaneous endoscopic colostomy (PEC), and 26 patients received PEG/J combined stents. These procedures were performed in different clinical conditions, including enteral nutrition (n = 329), decompression combined enteral nutrition (n = 133), decompression of the gastrointestinal tract (n = 103), enteral nutrition combined bile refeeding (n = 5), perioperative applications (n = 4), and coloclysis (n = 4). Tubes were successfully placed in 578 patients (98.0%) in an average time of (7.5 +/- 1.9) min in PEG, (17.7 +/- 4.2) min in PEGJ, (14.8 +/- 2.1) min in DPEJ, (12.3 +/- 2.5) min in PED, (11.3 +/- 2.6) min in PEC, and (30.2 +/- 5.2) min in PEG/J combined stent, respectively. No procedure-related complications were observed. Major complications were found in 6 patients (1.04%) and minor complications in 36 patients (6.23%). The duration of tube functioning was (168.37 +/- 198.64) d.
PEG/PEJ are easy to handle, effective, safe, and convenient for nursing. The endoscopic method of tube placement can be performed at the bedside and allow for enteral feeding, gastrointestinal decompression, and internal biliary drainage to be rapidly and efficiently achieved.
总结经皮内镜下胃造口术(PEG)/经皮内镜下空肠造口术(PEJ)的临床经验。
回顾性分析2001年7月至2007年12月在我院接受PEG或PEJ的578例患者的临床资料。分析的数据包括这些操作的类型、目的、持续时间、成功率及并发症。
578例患者中,247例行PEG,293例行经皮内镜下胃空肠造口术(PEGJ),4例行经皮内镜下十二指肠造口术(PED),4例行直接经皮内镜下空肠造口术(DPEJ),4例行经皮内镜下结肠造口术(PEC),26例置入PEG/J联合支架。这些操作在不同临床情况下进行,包括肠内营养(n = 329)、减压联合肠内营养(n = 133)、胃肠道减压(n = 103)、肠内营养联合胆汁回输(n = 5)、围手术期应用(n = 4)及结肠灌洗(n = 4)。578例患者置管成功(98.0%),PEG平均置管时间为(7.5±1.9)分钟,PEGJ为(17.7±4.2)分钟,DPEJ为(14.8±2.1)分钟,PED为(12.3±2.5)分钟,PEC为(11.3±2.6)分钟,PEG/J联合支架为(30.2±5.2)分钟。未观察到与操作相关的并发症。6例患者出现严重并发症(1.04%),36例患者出现轻微并发症(6.23%)。导管使用时间为(168.37±198.64)天。
PEG/PEJ操作简便、有效、安全且护理方便。内镜下置管方法可在床边进行,能快速有效地实现肠内营养、胃肠道减压及内胆汁引流。