Clarkston W K, Smith O J, Walden J M
Department of Gastroenterology, University of Missouri, Kansas City School of Medicine.
South Med J. 1990 Dec;83(12):1433-6. doi: 10.1097/00007611-199012000-00015.
To assess morbidity, mortality, and benefit associated with percutaneous endoscopic gastronomy (PEG), we retrospectively studied 42 patients who had had PEG. Mortality was exceptionally high during the first 60 days after PEG (43%), and then stabilized. In nearly half of the cases (20/42) the PEG tube was removed during the first 60 days because of either death or improvement. Patients with malignancy had a significantly higher morbidity and 60-day mortality than the neurologically impaired. We concluded that patients should be carefully selected for PEG because early mortality is high; a 60-day trial of soft nasogastric feedings should be considered before PEG, and could reduce by nearly half the number of patients failing to receive long-term benefit; and patients with malignancy have significantly greater morbidity and mortality after PEG and may not receive the same advantage from the procedure.
为评估经皮内镜下胃造口术(PEG)相关的发病率、死亡率及获益情况,我们对42例行PEG的患者进行了回顾性研究。PEG术后最初60天内死亡率极高(43%),随后趋于稳定。近半数病例(20/42)在最初60天内由于死亡或病情改善而拔除了PEG管。恶性肿瘤患者的发病率和60天死亡率显著高于神经功能受损患者。我们得出结论,应谨慎选择PEG患者,因为早期死亡率较高;在进行PEG之前应考虑进行为期60天的软鼻饲试验,这可使无法获得长期获益的患者数量减少近一半;恶性肿瘤患者PEG术后的发病率和死亡率显著更高,可能无法从该手术中获得同样的益处。