Fay D E, Poplausky M, Gruber M, Lance P
Department of Medicine, State University of New York School of Medicine and Biomedical Sciences, Veterans Administration Medical Center, Buffalo.
Am J Gastroenterol. 1991 Nov;86(11):1604-9.
The use of percutaneous endoscopic gastrostomy (PEG) tubes for enteral feeding is widespread, although their superiority to other feeding devices, such as nasoenteric tubes (NET), has not been substantiated. We retrospectively compared clinical outcomes in patients who received enteral feeding via PEG (n = 80) or NET (n = 29) from 1984 to 1988. Mean follow-up was 192 days in the PEG group and 141 days in the NET group. Changes in nutritional and performance status were similar in both groups. Aspiration pneumonia occurred within 14 days of tube placement in 6% and 24% (p = 0.01) of the PEG and NET patients, respectively. With the exception of tube replacement, cumulative rates of minor and major complications (including aspiration pneumonia) were similar in both groups during follow-up. None of the clinical variables that were assessed correlated with the development of aspiration pneumonia. Mortality was similar in both groups. These results suggest that, for long-term enteral feeding, PEG offers no substantial advantages over NET with respect to patient nutrition, performance, or survival. The reasons for the observed difference in short-term aspiration pneumonia rates are unknown, and must be investigated prospectively.
经皮内镜下胃造口术（PEG）管用于肠内营养喂养的情况很普遍，尽管其相较于其他喂养装置（如鼻肠管（NET））的优越性尚未得到证实。我们回顾性比较了1984年至1988年间通过PEG（n = 80）或NET（n = 29）接受肠内营养喂养患者的临床结局。PEG组的平均随访时间为192天，NET组为141天。两组患者的营养和身体状况变化相似。PEG组和NET组分别有6%和24%（p = 0.01）的患者在置管后14天内发生吸入性肺炎。除了更换管道外，随访期间两组轻微和严重并发症（包括吸入性肺炎）的累积发生率相似。所评估的临床变量均与吸入性肺炎的发生无关。两组的死亡率相似。这些结果表明，对于长期肠内营养喂养，PEG在患者营养、身体状况或生存率方面相对于NET并无实质性优势。观察到的短期吸入性肺炎发生率差异的原因尚不清楚，必须进行前瞻性研究。
