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经皮内镜胃造瘘术对神经源性吞咽困难并反复肺炎患者的喂养效果。

Percutaneous endoscopic gastrostomy feeding effects in patients with neurogenic dysphagia and recurrent pneumonia.

机构信息

Division of Gastroenterology, Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea.

Department of Hospital Medicine, Inha University School of Medicine, Incheon, South Korea.

出版信息

Ther Adv Respir Dis. 2021 Jan-Dec;15:1753466621992735. doi: 10.1177/1753466621992735.

Abstract

BACKGROUND

Percutaneous endoscopic gastrostomy (PEG) feeding provides enteral nutrition to patients with neurological dysphagia. However, the conditions in which PEG should be applied to prevent pneumonia remain unclear. We aimed to evaluate the effect of PEG for patients with neurological dysphagia in preventing pneumonia.

METHODS

We undertook a retrospective data review of 232 patients with neurological dysphagia who had undergone PEG from January 2008 to December 2018 at Inha University Hospital, in Incheon, Korea. We excluded patients who had not been followed up 6 months pre- and post-PEG feeding. In total, our study comprised 42 patients. We compared pneumonia episodes and incidence pre- and post-PEG.

RESULTS

During the median post-PEG follow-up period, the 6-month pneumonia incidence among patients who had undergone PEG had decreased [median 0.3 (interquartile range (IQR) 0.0-0.7) 0.1 (IQR 0.1-0.3) episodes,  = 0.04]. In a multiple mixed model, PEG did not decrease the incidence of pneumonia (= 0.76). However, the association between PEG and the incidence of pneumonia differed significantly depending on the presence or absence of recurrent pneumonia (< 0.001).

CONCLUSIONS

PEG could effectively reduce the incidence of pneumonia in patients with neurogenic dysphagia, especially in those who had experienced recurrent pneumonia.

摘要

背景

经皮内镜胃造口术(PEG)为有神经源性吞咽困难的患者提供肠内营养。然而,应用 PEG 预防肺炎的条件尚不清楚。我们旨在评估 PEG 对神经源性吞咽困难患者预防肺炎的效果。

方法

我们回顾性分析了 2008 年 1 月至 2018 年 12 月在韩国仁川仁荷大学医院接受 PEG 的 232 例神经源性吞咽困难患者的数据。我们排除了在 PEG 喂养前和喂养后 6 个月未进行随访的患者。共有 42 例患者符合研究标准。我们比较了 PEG 前后肺炎发作和发病率。

结果

在 PEG 后中位随访期间,接受 PEG 的患者在 6 个月时肺炎的发生率下降[中位数 0.3(四分位距(IQR)0.0-0.7) 0.1(IQR 0.1-0.3)次,= 0.04]。在多混合模型中,PEG 并不能降低肺炎的发生率(= 0.76)。然而,PEG 与肺炎发生率之间的关联在是否存在复发性肺炎时差异显著(<0.001)。

结论

PEG 可有效降低神经源性吞咽困难患者肺炎的发生率,特别是在经历过复发性肺炎的患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7c1/8010805/871b528fa565/10.1177_1753466621992735-fig1.jpg

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