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重度残疾儿童经皮内镜下胃造口术与外科胃造口术的比较

Comparison of Percutaneous Endoscopic Gastrostomy and Surgical Gastrostomy in Severely Handicapped Children.

作者信息

Kim June, Lee Min, Kim Soon Chul, Joo Chan Uhng, Kim Sun Jun

机构信息

Department of Pediatrics, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.; Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.

出版信息

Pediatr Gastroenterol Hepatol Nutr. 2017 Mar;20(1):27-33. doi: 10.5223/pghn.2017.20.1.27. Epub 2017 Mar 27.

Abstract

PURPOSE

Gastrostomy is commonly used procedures to provide enteral nutrition support for severely handicapped patients. This study aimed to identify and compare outcomes and complications associated with percutaneous endoscopic gastrostomy (PEG) and surgical gastrostomy (SG).

METHODS

A retrospective chart review of 51 patients who received gastrostomy in a single tertiary hospital from January 2000 to May 2016 was performed. We analyzed the patients and the complications caused by the procedures.

RESULTS

Among the 51 patients, 26 had PEG and 25 had SG. Four cases in the SG group had fundoplication for gastroesophageal reflux disease. PEG and SG groups were followed up for an average of 29 months and 44 months. Major complications occurred in 19.2% of patients in the PEG group and 20.0% in the SG group, but significant differences between the groups were not observed. Minor complications occurred in 15.4% of patients in the PEG group and 52.0% in the SG group. Minor complications were significantly lower in the PEG group than in the SG group (=0.006). The average use of antibiotics in the PEG and SG groups was 6.2 days and 15.7 days (=0.002). Thirteen patients died of underlying disease but not related to gastrostomy, and only one patient died due to complications associated with general anesthesia.

CONCLUSION

The duration of antibiotics use and incidence of minor complications were significantly lower in the PEG group than those in the SG group. Early PEG could be recommended for nutritional supports.

摘要

目的

胃造口术是为严重残疾患者提供肠内营养支持的常用方法。本研究旨在确定并比较经皮内镜下胃造口术(PEG)和外科胃造口术(SG)的结局及并发症。

方法

对2000年1月至2016年5月在一家三级医院接受胃造口术的51例患者进行回顾性病历审查。我们分析了患者及手术引起的并发症。

结果

51例患者中,26例行PEG,25例行SG。SG组有4例因胃食管反流病行胃底折叠术。PEG组和SG组的平均随访时间分别为29个月和44个月。PEG组19.2%的患者发生主要并发症,SG组为20.0%,但两组间未观察到显著差异。PEG组15.4%的患者发生轻微并发症,SG组为52.0%。PEG组的轻微并发症明显低于SG组(P=0.006)。PEG组和SG组抗生素的平均使用天数分别为6.2天和15.7天(P=0.002)。13例患者死于基础疾病而非与胃造口术相关的原因,仅1例患者因全身麻醉相关并发症死亡。

结论

PEG组抗生素使用时间和轻微并发症发生率明显低于SG组。对于营养支持,可推荐早期行PEG。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e937/5385304/1b41ff21c8be/pghn-20-27-g001.jpg

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