Römkens T E H, de Jong D J, Kristinsson J O, Wanten G J
Universitair Medisch Centrum St Radboud, afd. Maag-, Darm- en Leverziekten, Nijmegen.
Ned Tijdschr Geneeskd. 2008 Aug 23;152(34):1857-61.
Four patients, aged 67, 52, 56 and 64 years, respectively, undergoing percutaneous colostomy or jejunostomy are presented to illustrate current options for percutaneous endoscopic access to the digestive tract. The first patient had Parkinson's disease and required percutaneous jejunostomy for continuous post-pyloric administration of medication. The second patient had impaired gastric emptying due to gastric graft-versus-host disease following bone marrow transplantation. He was successfully treated with percutaneous jejunostomy, which was removed 2 years later after full recovery. The third patient had severe constipation due to the use ofmorphinomimetic analgesics. She received percutaneous caecostomy for colonic lavage and desufflation. The fourth patient had combined constipation and sphincteric insufficiency. Although the percutaneous endoscopic colostomy was clinically successful, the catheter had to be removed due to local pain and abscess formation.
介绍了4例分别为67岁、52岁、56岁和64岁的患者,他们正在接受经皮结肠造口术或空肠造口术,以说明目前经皮内镜进入消化道的选择。第一位患者患有帕金森病,需要经皮空肠造口术以便持续进行幽门后给药。第二位患者因骨髓移植后发生胃移植物抗宿主病导致胃排空障碍。他成功接受了经皮空肠造口术治疗,完全康复2年后造口管拔除。第三位患者因使用拟阿片类镇痛药导致严重便秘。她接受了经皮盲肠造口术用于结肠灌洗和排气。第四位患者同时存在便秘和括约肌功能不全。尽管经皮内镜结肠造口术在临床上取得成功,但由于局部疼痛和脓肿形成,导管不得不拔除。