Pih Gyu Young, Na Hee Kyong, Hong Suk-Kyung, Ahn Ji Yong, Lee Jeong Hoon, Jung Kee Wook, Kim Do Hoon, Choi Kee Don, Song Ho June, Lee Gin Hyug, Jung Hwoon-Yong
Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Nutritional Support Team, Asan Medical Center, Seoul, Korea.
Clin Endosc. 2020 Nov;53(6):705-716. doi: 10.5946/ce.2019.196. Epub 2020 Mar 31.
BACKGROUND/AIMS: Percutaneous endoscopic gastrostomy (PEG) is usually performed on patients with chronic underlying diseases in the general ward (GW). This study evaluated the clinical outcomes of PEG performed on patients in the surgical intensive care unit (SICU) compared with those of PEG performed in the GW.
The medical records of 27 patients in the SICU and 263 in the GW, who underwent PEG between January 2013 and July 2017, were retrospectively reviewed.
The median age of the 27 SICU patients was 66 years, and their median body mass index was 21.1 kg/m2. In the SICU group, the median baseline Sequential Organ Failure Assessment (SOFA) score was 4, and the median Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 16. The median interval between surgery and PEG in SICU patients was 30 days, with a PEG failure rate of 3.7%. Acute complications in SICU patients included bleeding (7.4%) and ileus (11.1%), while chronic complications included aspiration pneumonia (7.4%) and tube obstruction (3.7%). The rates of acute and chronic complications did not differ significantly between the SICU and GW groups. The 30-day mortality rate was 14.8% in SICU patients and 5.3% in GW patients (p=0.073).
PEG is a safe and feasible method of enteral feeding for critically ill patients who require ICU care after surgery.
背景/目的：经皮内镜下胃造口术（PEG）通常在普通病房（GW）对患有慢性基础疾病的患者进行。本研究评估了在外科重症监护病房（SICU）对患者进行PEG的临床结果，并与在GW进行PEG的结果进行比较。
回顾性分析2013年1月至2017年7月期间在SICU接受PEG的27例患者和在GW接受PEG的263例患者的病历。
27例SICU患者的中位年龄为66岁，中位体重指数为21.1kg/m²。在SICU组中，基线序贯器官衰竭评估（SOFA）评分的中位数为4，急性生理与慢性健康状况评估II（APACHE II）评分的中位数为16。SICU患者手术与PEG之间的中位间隔时间为30天，PEG失败率为3.7%。SICU患者的急性并发症包括出血（7.4%）和肠梗阻（11.1%），而慢性并发症包括吸入性肺炎（7.4%）和管道阻塞（3.7%）。SICU组和GW组的急性和慢性并发症发生率差异无统计学意义。SICU患者的30天死亡率为14.8%，GW患者为5.3%（p=0.073）。
对于术后需要重症监护病房护理的重症患者，PEG是一种安全可行的肠内营养方法。
