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评估胃造口管在小儿脑瘫患者中的并发症和体重结局。

Evaluation of Complications and Weight Outcomes in Pediatric Cerebral Palsy Patients With Gastrostomy Tubes.

机构信息

Division of Trauma and Acute Care Surgery, Department of Surgery, The University of North Carolina, Chapel Hill, NC, USA.

Gillings School of Public Health, The University of North Carolina, Chapel Hill, NC, USA.

出版信息

Am Surg. 2023 Apr;89(4):632-640. doi: 10.1177/00031348211034753. Epub 2021 Jul 28.

DOI:10.1177/00031348211034753
PMID:34318698
Abstract

BACKGROUND

Feeding difficulties are common in children with cerebral palsy (CP). The goal of this study was to examine pediatric CP patients undergoing gastrostomy tube (G tube) placement and assess the association between patient characteristics and weight after 3 months, 6 months, and 1 year.

METHODS

This was a retrospective study of all pediatric patients with CP who received a G tube placement between April 2014 and December 2017 at a single institution. Bivariate analysis was used to examine association between patient characteristics and the primary outcome of improvement in weight Z score at 3, 6, and 12 months.

RESULTS

Of 63 patients who received a G tube, 81% had an increase in Z score at 3 months, 44% at 6 months, and 64% at 12 months. By 12 months, factors associated with a positive Z score change included moderate and severe malnutrition, lack of prior G tube, and fewer comorbidities. The majority (69.8%) of patients experienced complications. Seven (11%) patients died, with only 1 death related to G tube placement.

DISCUSSION

The use of G tubes in CP patients resulted in an increase in an improvement in nutritional status for the majority of patients over the course of a year. Although most complications were minor, patients had a high complication rate and frequently visited the emergency department, highlighting the need for standardized education and follow-up among this patient population.

摘要

背景

脑瘫(CP)患儿常存在喂养困难。本研究旨在探讨行胃造口管(G 管)置管术的小儿 CP 患者的特征,并评估患者特征与置管后 3、6、12 个月时体重的相关性。

方法

这是一项单中心回顾性研究,纳入了 2014 年 4 月至 2017 年 12 月期间行 G 管置管的所有小儿 CP 患者。采用双变量分析来评估患者特征与体重 Z 评分改善的主要结局(3、6、12 个月时)之间的相关性。

结果

63 例行 G 管置管的患者中,81%在 3 个月时体重 Z 评分增加,44%在 6 个月时增加,64%在 12 个月时增加。至 12 个月时,与 Z 评分改善相关的因素包括中重度营养不良、无既往 G 管置管史以及合并症较少。大多数(69.8%)患者发生了并发症。7 例(11%)患者死亡,仅 1 例死亡与 G 管置管相关。

讨论

G 管在 CP 患者中的应用使大多数患者在 1 年内营养状况得到改善。尽管大多数并发症为轻微,但患者的并发症发生率较高,且经常到急诊科就诊,这凸显了在该患者人群中进行标准化教育和随访的必要性。

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