Martins Fernanda Prata, Sousa Maris Celia Batista de, Ferrari Angelo Paulo
Hospital Israelita Albert Einstein, São Paulo, Brasil.
Arq Gastroenterol. 2011 Oct-Dec;48(4):231-5. doi: 10.1590/s0004-28032011000400003.
Enteral feeding is indicated for patients unable to maintain appropriate oral intake, and percutaneous endoscopic gastrostomy (PEG) is the most adequate long-term enteral access. Peristomal infections are the most common complications of PEG, occurring in up to 8% of patients, despite the use of prophylactic antibiotics. The "introducer" PEG-gastropexy technique avoids PEG tube passage through the oral cavity, preventing microorganisms' dislodgment to the peristomal site.
To compare the incidence of peristomal wound infection at 7-day post-procedure after conventional "pull" technique versus a new "introducer" PEG-gastropexy kit. Secondary outcomes included success rates, procedure time, and other complications.
Eighteen patients referred for PEG placement between June and December 2010 were randomly assigned to "pull" PEG with antibiotics or "introducer" PEG-gastropexy technique without antibiotics.
Overall success rate for both methods was 100%, although mean procedure duration was higher in the "introducer" PEG-gastropexy group (12.6 versus 6.4 minutes, P = 0.0166). Infection scores were slightly higher in patients who underwent "pull" PEG with antibiotics compared with "introducer" PEG-gastropexy without antibiotics (1.33 ± 0.83 versus 0.75 ± 0.67, P = 0.29).
Although procedure duration was longer in the "introducer" PEG-gastropexy, infection scores were marginally higher in the "pull" PEG technique.
对于无法维持适当经口摄入量的患者，肠内喂养是必要的，而经皮内镜下胃造口术（PEG）是最适宜的长期肠内营养途径。尽管使用了预防性抗生素，但造口周围感染仍是PEG最常见的并发症，发生率高达8%的患者。“导入器”PEG胃固定术可避免PEG管经口腔插入，防止微生物进入造口周围区域。
比较传统“牵拉”技术与新型“导入器”PEG胃固定术套件术后7天造口周围伤口感染的发生率。次要结局包括成功率、手术时间和其他并发症。
2010年6月至12月期间转诊接受PEG置入的18例患者被随机分配接受使用抗生素的“牵拉”PEG或不使用抗生素的“导入器”PEG胃固定术。
两种方法的总体成功率均为100%，尽管“导入器”PEG胃固定术组的平均手术持续时间更长（12.6分钟对6.4分钟，P = 0.0166）。与未使用抗生素的“导入器”PEG胃固定术相比，接受使用抗生素的“牵拉”PEG的患者感染评分略高（1.33±0.83对0.75±0.67，P = 0.29）。
尽管“导入器”PEG胃固定术的手术时间更长，但“牵拉”PEG技术的感染评分略高。
