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经皮内镜下胃造口管置入术在儿童中可被认为是安全的:一项单中心11年回顾性分析。

Percutaneous Endoscopic Gastrostomy Tubes Can Be Considered Safe in Children: A Single-Center 11-Year Retrospective Analysis.

作者信息

Jeličić Kadić Antonia, Radošević Tea, Žitko Vanda, Despot Ranka, Pogorelić Zenon, Llorente Muñoz Carlos Martin, Runjić Edita, Kovačević Tanja, Ćatipović Ardalić Tatjana, Polić Branka, Markić Joško

机构信息

Department of Pediatrics, University Hospital of Split, 21 000 Split, Croatia.

School of Medicine, University of Split, 21 000 Split, Croatia.

出版信息

Medicina (Kaunas). 2021 Nov 12;57(11):1236. doi: 10.3390/medicina57111236.

Abstract

When the human body is disabled to naturally ingest food through the mouth, enteral or parenteral nutritional support should be started. Percutaneous gastrostomy (PEG) is a flexible feeding tube that is inserted into the stomach through the abdominal wall in patients who will need long-term enteral nutrient intake. The aim of this study is to analyze clinical characteristic of children at the time of PEG placement as well as to determine indications, complications and outcomes associated with PEG at the Department of Pediatrics of the University Hospital of Split. : Retrospective analysis of the medical records of patients treated from 2010 to 2020 was performed. The following data were collected from medical records: age, gender, information about nasogastric feeding before PEG placement, indication for PEG insertion, duration of PEG, procedure-related complications and treatment outcomes. Malnutrition was determined according to the z-score range for BMI for age and sex. According to the indication for PEG placement, patients were divided into five categories: central nervous system (CNS) diseases, neuromuscular diseases, genetic disorders, metabolic diseases, and group of children with polytrauma. : A total of 40 patients with median age of 110 months were included in study. At the time of PEG placement, most patients had deviations in body weight and height compared to expected values for age and sex. The most common underlying diagnoses were diseases of the central nervous system. Minor complications were found in 13 (35%) of patients. One patient (2.7%) developed major complication (gastrocolic fistula) and consequently underwent reoperation. The median duration of PEG in patients with complications before the need for replacement was 27 months, and in patients without complications, 43 months. : Negative deviations of z-score body weight, body height, and body mass index could indicate the need for possible earlier placement of PEG. PEG can be considered as a safe therapeutic option in children since PEG-related complications, mostly in minor forms, were found in a small number of patients.

摘要

当人体无法通过口腔自然摄入食物时,应开始肠内或肠外营养支持。经皮胃造口术(PEG)是一种可弯曲的喂食管,通过腹壁插入需要长期肠内营养摄入的患者的胃中。本研究的目的是分析斯普利特大学医院儿科患者进行PEG置管时的临床特征,并确定与PEG相关的适应症、并发症和结局。:对2010年至2020年接受治疗的患者的病历进行回顾性分析。从病历中收集以下数据:年龄、性别、PEG置管前鼻饲的信息、PEG插入的适应症、PEG的持续时间、与手术相关的并发症和治疗结局。根据年龄和性别的BMI z评分范围确定营养不良情况。根据PEG置管的适应症,患者分为五类:中枢神经系统(CNS)疾病、神经肌肉疾病、遗传性疾病、代谢性疾病以及多发伤儿童组。:共有40名中位年龄为110个月的患者纳入研究。在PEG置管时,与年龄和性别的预期值相比,大多数患者的体重和身高存在偏差。最常见的潜在诊断是中枢神经系统疾病。13名(35%)患者出现轻微并发症。1名患者(2.7%)发生严重并发症(胃结肠瘘),因此接受了再次手术。有并发症的患者在需要更换之前PEG的中位持续时间为27个月,无并发症的患者为43个月。:体重、身高和体重指数z评分的负偏差可能表明需要更早进行PEG置管。PEG可被视为儿童的一种安全治疗选择,因为在少数患者中发现了与PEG相关的并发症,大多为轻微形式。

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