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经皮内镜下胃造口术(PEG)置管的可接受性、结果及患者生活质量

Acceptability and outcomes of percutaneous endoscopic gastrostomy (PEG) tube placement and patient quality of life.

作者信息

Hossein Somi Mohammad, Leili Maghbouli, Hossein Antikchi Mohammad

机构信息

Department of Gastroenterology, Imam Reza Hospital of Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Turk J Gastroenterol. 2011;22(2):128-33. doi: 10.4318/tjg.2011.0180.

Abstract

BACKGROUND/AIMS: Since its description in 1980, percutaneous endoscopic gastrostomy has been a widely used method for insertion of a gastrostomy tube in patients who are unable to swallow or maintain adequate nutrition. This study aimed to assess the perspectives of patients/caregivers in our society regarding the acceptability of percutaneous endoscopic gastrostomy tube placement and to evaluate the outcomes.

METHODS

One hundred consecutive adults referred to our unit to be considered for primary percutaneous endoscopic gastrostomy feeding at Imam Reza Hospital of Tabriz University of Medical Sciences were evaluated prospectively from October 2007 to June 2009. The nutritional status of patients, complications and quality of life were assessed after percutaneous endoscopic gastrostomy insertion for six months. The data were analyzed using SPSS software.

RESULTS

Indications for percutaneous endoscopic gastrostomy were neurologic in 66 patients and recurrent pulmonary aspiration in 14 intensive care unit adult patients. Minor complications included percutaneous endoscopic gastrostomy site infection in 8 patients and tube blockage in 5 patients. Oral feeding was resumed in 27% of the patients and the tube was removed subsequently after 3-6 months; 42 patients died due to primary diseases (in 1-6 months). The Quality of Life Index scores pre-percutaneous endoscopic gastrostomy placement and 6 months after percutaneous endoscopic gastrostomy averaged 19.25±11.85 and 30.08±27.74, respectively. A similarly significant difference was also found between mean Quality of Life Index scores pre- and post-percutaneous endoscopic gastrostomy placement (p<0.005).

CONCLUSIONS

Percutaneous endoscopic gastrostomy is a minimally invasive gastrostomy method with low morbidity and mortality rates, and is easy to follow-up and to replace when blockage occurs.

摘要

背景/目的:自1980年经皮内镜下胃造口术被描述以来,它已成为一种广泛应用于无法吞咽或维持足够营养患者的胃造口管插入方法。本研究旨在评估我们社会中患者/护理人员对经皮内镜下胃造口管置入可接受性的看法,并评估其结果。

方法

2007年10月至2009年6月,对连续100例转诊至大不里士医科大学伊玛目礼萨医院考虑进行初次经皮内镜下胃造口术喂养的成年患者进行前瞻性评估。在经皮内镜下胃造口术插入6个月后评估患者的营养状况、并发症和生活质量。使用SPSS软件分析数据。

结果

经皮内镜下胃造口术的适应证中,66例患者为神经系统疾病,14例重症监护病房成年患者为反复肺误吸。轻微并发症包括8例患者发生经皮内镜下胃造口术部位感染和5例患者出现管堵塞。27%的患者恢复经口喂养,随后在3 - 6个月后拔除胃造口管;42例患者因原发性疾病死亡(在1 - 6个月内)。经皮内镜下胃造口术置入前和置入后6个月的生活质量指数评分平均分别为19.25±11.85和30.08±27.74。经皮内镜下胃造口术置入前后的平均生活质量指数评分之间也发现了类似的显著差异(p<0.005)。

结论

经皮内镜下胃造口术是一种微创胃造口术方法,发病率和死亡率低,易于随访,堵塞时易于更换。

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