Department of Paediatric Surgery, Evelina London Children's Hospital.
GKT King's College London Medical School.
J Pediatr Gastroenterol Nutr. 2021 Apr 1;72(4):528-531. doi: 10.1097/MPG.0000000000003016.
The aim of the study was to determine the prevalence of gastrostomy in a paediatric population.
A population-based cross-sectional point prevalence study of paediatric gastrostomy was performed. Patients included were ages 0 to 19 years, living within 3 inner-city London boroughs; Southwark, Lambeth, and Lewisham. Patients were identified as having a gastrostomy in situ via Home Enteral Nutrition (HEN) and community nursing databases. Electronic healthcare records were scrutinised to confirm current use of a gastrostomy. The main outcome measures were the point prevalence of gastrostomy in the paediatric population (gastrostomies/100,000 children), primary diagnosis, indication underlying gastrostomy insertion, and age at insertion.
The total population studied was 946,709, of whom 213,920 were of age 0 to 19 years. Of these, 179 had a gastrostomy in situ giving a point prevalence for gastrostomy in the paediatric population of 83.7 (95% confidence interval [CI]: 71.4-96.0)/100,000 children. This varied between age groups: 0 to 4 years: 79.6 (57.3-102.0)/100,000, 5 to 9 years: 116.3 (88.7-143.9)/100,000, 10 to 14: years 87.9 (61.9-113.9)/100,000 and 15 to 19: years 41.4 (22.1-60.1)/100,000. The most common primary diagnoses were neurological disorders (57.1%), and structural abnormalities (16.2%). Unsafe swallow was the most common indication (61%), followed by nutritional or fluid supplementation (28.6%), and behavioural reasons (8.7%). The majority (85.1%) of gastrostomies were inserted under the age of 2 years.
This is the first UK population-based study of paediatric gastrostomy, identifying a point prevalence of 84/100,000 children. The peak prevalence is in children ages 5 to 9 years. Gastrostomy insertion after a child reaches school age is uncommon.
本研究旨在确定小儿人群中胃造口术的流行率。
进行了一项基于人群的小儿胃造口术的横断面时点患病率研究。纳入的患者年龄为 0 至 19 岁，居住在伦敦 3 个内城区内：南华克、兰贝斯和刘易舍姆。通过家庭肠内营养（HEN）和社区护理数据库确定患者存在原位胃造口术。仔细审查电子医疗记录以确认当前使用胃造口术。主要结局指标为小儿人群中胃造口术的时点患病率（胃造口术/每 10 万名儿童）、主要诊断、胃造口术插入的潜在适应证以及插入时的年龄。
研究的总人群为 946709 人，其中 213920 人为 0 至 19 岁。其中，179 人存在原位胃造口术，小儿人群中胃造口术的时点患病率为 83.7（95%置信区间[CI]：71.4-96.0）/每 10 万名儿童。这在不同年龄组之间有所差异：0 至 4 岁：79.6（57.3-102.0）/每 10 万名儿童，5 至 9 岁：116.3（88.7-143.9）/每 10 万名儿童，10 至 14 岁：87.9（61.9-113.9）/每 10 万名儿童和 15 至 19 岁：41.4（22.1-60.1）/每 10 万名儿童。最常见的主要诊断是神经障碍（57.1%）和结构异常（16.2%）。不安全吞咽是最常见的适应证（61%），其次是营养或液体补充（28.6%）和行为原因（8.7%）。大多数（85.1%）胃造口术是在 2 岁以下插入的。
这是英国第一项关于小儿胃造口术的基于人群的研究，确定了每 10 万名儿童中有 84 例的时点患病率。峰值患病率出现在 5 至 9 岁的儿童中。儿童达到学龄后插入胃造口术并不常见。
