Hassett J M, Sunby C, Flint L M
Department of Surgery, State University of New York, Buffalo.
Surg Gynecol Obstet. 1988 Nov;167(5):383-8.
To clarify the relationship of aspiration pneumonia (ASP) to feeding gastrostomy in neurologically disabled patients, we reviewed the charts of 87 patients who had a feeding gastrostomy for enteral access. We looked for evidence of gastroesophageal reflux (GER) and ASP. Prior to gastrostomy, the frequency of ASP was 29 of 87 patients. One year after gastrostomy, the crude frequency of ASP (17 of 52 patients) was not significantly improved. After gastrostomy, ASP was still observed in 18 of the 29 patients in whom ASP had been identified prior to gastrostomy. In the 58 patients in whom there was no clinical evidence of ASP prior to gastrostomy, 17 demonstrated ASP after gastrostomy. Over-all, 39 of 87 patients died. Mortality at one year (32) was greater in patients with documented ASP (p = 0.025). The preoperative presence of GER was associated with postoperative ASP (predictive value of 0.70). The preoperative presence of both GER and ASP was associated with postoperative ASP in all of the patients we studied.
为明确神经功能障碍患者中吸入性肺炎（ASP）与胃造口喂养之间的关系，我们回顾了87例行胃造口以建立肠内营养通路患者的病历。我们查找了胃食管反流（GER）和ASP的证据。在胃造口术前，87例患者中有29例发生ASP。胃造口术后1年，ASP的粗发病率（52例患者中有17例）无显著改善。胃造口术后，胃造口术前已确诊ASP的29例患者中有18例仍发生ASP。在胃造口术前无ASP临床证据的58例患者中，17例在胃造口术后发生ASP。总体而言，87例患者中有39例死亡。有记录的ASP患者1年时的死亡率（32例）更高（p = 0.025）。术前存在GER与术后ASP相关（预测值为0.70）。在我们研究的所有患者中，术前同时存在GER和ASP与术后ASP相关。
