Ojo Omorogieva
Department of Acute and Continuing Care, University of Greenwich, London, UK.
Br J Nurs. 2011;20(1):34-8. doi: 10.12968/bjon.2011.20.1.34.
Dysphagic patients with functional guts often receive nutritional and hydration support through enteral feeding tubes. These include percutaneous endoscopic gastrostomy (PEG) and radiologically inserted gastrostomy (RIG) tubes. The balloon gastrostomy tube (BGT) as a primary tube of choice in tube-fed patients, including head and neck cancer patients, offers a new approach to enteral tube feeding in the community. There are complications associated with the use of enteral feeding tubes. This study compared the complication rates and the costs of PEG tubes and BGTs in patients on long-term enteral feeding in the community and looked at the possible use of BGTs as an alternative to PEG tubes.
The records of all 15 BGT-fed patients on the caseload and 15 randomly selected PEG tube-fed patients were reviewed. The study was based on two consecutive visits to these patients. Tube and stoma complications were clinically scored in order of increasing severity (0-10) and statistically tested. The prevalence of stoma and tube complications was expressed in percentages.
There was no significant difference (P>0.05) in the overall clinical scores between BGT-fed and PEG tube-fed patients at both initial and final visits. However, with regard to specific complications-infected sites, tube dislodgement, overgranulation, and infection with overgranulation-significant differences were observed between the two groups of patients at the initial and final visits. In addition, the total costs of inserting and managing BGTs were significantly higher than those for PEG tubes.
Although BGTs may be used as analternative to PEG tubes in patients on long-term enteral feeding in the community, the higher cost of using BGTs over PEG tubes should be considered when selecting feeding tubes for these patients.
有功能性肠道的吞咽困难患者常通过肠内喂养管接受营养和水分支持。这些喂养管包括经皮内镜下胃造口术（PEG）管和放射介入下胃造口术（RIG）管。球囊胃造口管（BGT）作为管饲患者（包括头颈癌患者）的首选主要管道，为社区肠内管饲提供了一种新方法。使用肠内喂养管会有并发症。本研究比较了社区中长期接受肠内喂养患者使用PEG管和BGT管的并发症发生率及成本，并探讨了BGT管作为PEG管替代品的可能性。
回顾了病例记录中所有15例使用BGT管喂养的患者以及15例随机选取的使用PEG管喂养的患者。该研究基于对这些患者的两次连续随访。对管道和造口并发症按严重程度递增顺序（0 - 10）进行临床评分并进行统计学检验。造口和管道并发症的发生率以百分比表示。
在初次和末次随访时，使用BGT管喂养和使用PEG管喂养的患者总体临床评分无显著差异（P>0.05）。然而，在特定并发症方面——感染部位、管道移位、过度肉芽组织形成以及伴有过度肉芽组织形成的感染——两组患者在初次和末次随访时存在显著差异。此外，插入和管理BGT管的总成本显著高于PEG管。
虽然在社区中长期接受肠内喂养的患者中，BGT管可作为PEG管的替代品使用，但在为这些患者选择喂养管时，应考虑到使用BGT管比PEG管成本更高。
