Schneider Andrea S, Schettler Anika, Markowski Andrea, Luettig Birgit, Kaufmann Birgit, Klamt Sabine, Lenzen Henrike, Momma Michael, Seipt Claudia, Lankisch Tim, Negm Ahmed A
Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School , Hannover , Germany.
Scand J Gastroenterol. 2014 Jul;49(7):891-8. doi: 10.3109/00365521.2014.916343. Epub 2014 Jun 4.
Percutaneous endoscopic gastrostomy (PEG) is often used for the feeding of patients with malnutrition due to dysphagia, and despite more than 30 years experience, numerous questions on its benefit remain. This was a prospective observational study to assess the safety of PEG.
One hundred and nineteen patients mean age 63 years (21-91 years) who were admitted to the Hannover Medical School between November 2010 and March 2012 and had an indication for PEG according to the German guidelines were included. Primary endpoints were the following: reason for indication, date of in-hospital mortality after PEG insertion, death within 3 months after PEG placement, and complications.
Most patients (54.6%) received PEG for dysphagia caused by tumors and second (29.4%) for neurologic diseases with a minor proportion of dementia (3%). About 73% of our patients had no complications at all and only 10% suffered severe effects. We saw only 1 case of aspiration, which did not lead to pneumonia. The 30-day mortality was 10%, and no patient died as a result of the PEG procedure. Significantly more patients with neurologic disorders died within 24 weeks of PEG placement than tumor patients (60% versus 27.7%, respectively, p = 0.002, n = 100).
It is important to select patients receiving PEG very carefully. The patients' indications, their primary disease, and their capability for mental cooperation are essential. If these aspects are taken into account, PEG is a safe method with few mainly mild complications.
经皮内镜下胃造口术（PEG）常用于因吞咽困难导致营养不良患者的喂养，尽管已有30多年的经验，但关于其益处仍存在诸多问题。这是一项前瞻性观察性研究，旨在评估PEG的安全性。
纳入2010年11月至2012年3月间入住汉诺威医学院、根据德国指南有PEG指征的119例患者，平均年龄63岁（21 - 91岁）。主要终点如下：指征原因、PEG置入后院内死亡日期、PEG置入后3个月内死亡以及并发症。
大多数患者（54.6%）因肿瘤导致的吞咽困难接受PEG，其次（29.4%）是因神经系统疾病，其中痴呆患者占比小（3%）。约73%的患者无任何并发症，仅10%出现严重后果。我们仅见1例误吸，未导致肺炎。30天死亡率为10%，无患者因PEG操作死亡。PEG置入后24周内，神经系统疾病患者的死亡人数显著多于肿瘤患者（分别为60%和27.7%，p = 0.002，n = 100）。
谨慎选择接受PEG的患者很重要。患者的指征、原发疾病以及精神合作能力至关重要。如果考虑到这些方面，PEG是一种安全的方法，主要并发症较少且大多为轻度。
