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经皮内镜下胃造口术(PEG)患者胃内压对误吸性肺炎发生的预后意义。

Prognostic significance of intragastric pressure for the occurrence of aspiration pneumonia in the patients with percutaneous endoscopic gastrostomy (PEG).

作者信息

Kudo Michiaki, Kanai Nobuyuki, Hirasawa Toshiaki, Asao Takayuki, Kuwano Hiroyuki

机构信息

Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, Faculty of Medicine, 3-39-22, Showamachi, Maebashi-city, Gunma, 371-8511, Japan.

出版信息

Hepatogastroenterology. 2008 Sep-Oct;55(86-87):1935-8.

Abstract

BACKGROUND/AIMS: Patients who have undergone a percutaneous endoscopic gastrostomy have been increasing. However, complications in serious patients are encountered more frequently. We attempted to examine the simple and new technique for the purpose of preventing complications in percutaneous endoscopic gastrostomy patients. By using our method of measuring of the intragastric pressure during the fasting period, the aspiration pneumonia of percutaneous endoscopic gastrostomy patient could be estimated.

METHODOLOGY

From January 2003 to December 2005, one hundred and thirty-two consecutive patients were examined. The intragastric pressure is measured by using a percutaneous endoscopic gastrostomy tube. This method is referenced as the technique for measuring the intra-abdominal pressure which is measured in the case of the abdominal compartment syndrome and the central venous pressure.

RESULTS

The mean intragastric pressure of patients with complicated pneumonia was 10.4 +/- 7.1 cm H2O, and 4.7 +/- 4.5 cm H2O with non-complicated pneumonia (p=0.0001). In cases of the patients in whom the tube immediately becomes dirty, the mean intragastric pressure was higher than in clean cases (p=0.0005).

CONCLUSIONS

There is a relationship between the intragastric pressure and the incidence of complications such as aspiration pneumonia. Our simple and easy technique can estimate the aspiration pneumonia.

摘要

背景/目的:接受经皮内镜下胃造口术的患者数量一直在增加。然而,重症患者的并发症更为常见。我们试图研究一种简单的新技术,以预防经皮内镜下胃造口术患者的并发症。通过使用我们在禁食期间测量胃内压的方法,可以估计经皮内镜下胃造口术患者的吸入性肺炎。

方法

2003年1月至2005年12月,对132例连续患者进行了检查。使用经皮内镜下胃造口管测量胃内压。该方法参考了在腹腔间隔综合征和中心静脉压测量时测量腹腔内压的技术。

结果

并发肺炎患者的平均胃内压为10.4±7.1cmH₂O,未并发肺炎患者的平均胃内压为4.7±4.5cmH₂O(p=0.0001)。在胃管立即变脏的患者中,平均胃内压高于胃管清洁的患者(p=0.0005)。

结论

胃内压与吸入性肺炎等并发症的发生率之间存在关联。我们简单易行的技术可以估计吸入性肺炎。

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