Zhang Ling, Cao Jing, Hu Ji-Hong
Hunan Children's Hospital, Rehabilitation Center, Changsha, Hunan, China.
Medicine (Baltimore). 2025 Apr 25;104(17):e42021. doi: 10.1097/MD.0000000000042021.
This study explores the clinical application value of percutaneous endoscopic gastrostomy (PEG) in children with dysphagia after brain injury. Children with dysphagia after brain injury were selected and randomly divided into a treatment group and a control group using a random number table method, with 42 cases in each group. The control group received nutritional support using indwelling nasogastric tube technology, while the treatment group received nutritional support using PEG technology. Both groups received the same tube feeding nutrient solution. At the same time, both groups of patients received comprehensive training methods including oral sensation training, oral exercise training, and physical therapy for swallowing dysfunction. Weight, total serum protein, serum albumin, and hemoglobin of the patients were measured 1 day before treatment and 28 days after treatment, respectively. The degree of dysphagia was evaluated by the water swallow test and the dysphagia disorders survey of each patient 1 day before treatment and 28 days after treatment, respectively. Adverse events such as gastrointestinal bleeding, aspiration pneumonia, and reflux esophagitis were recorded. After 28 days of treatment, both the control group and the PEG group showed an increase in body weight, total serum protein, serum albumin, and hemoglobin compared to before treatment (P < .05), and the PEG group showed a more significant increase than the control group (P < .05). At the same time, swallowing function improved more significantly in the PEG group (P < .05), and the incidence of adverse events was lower compared to the control group (P < .05). The comprehensive training method for swallowing disorders combined with enteral PEG nutrition has a definite effect on children with swallowing disorders after traumatic brain injury.
本研究探讨经皮内镜下胃造口术(PEG)在脑损伤后吞咽困难儿童中的临床应用价值。选取脑损伤后吞咽困难的儿童,采用随机数字表法随机分为治疗组和对照组,每组42例。对照组采用留置鼻胃管技术给予营养支持,治疗组采用PEG技术给予营养支持。两组均给予相同的管饲营养液。同时,两组患者均接受包括口腔感觉训练、口腔运动训练及吞咽功能障碍物理治疗在内的综合训练方法。分别在治疗前1天和治疗后28天测量患者的体重、总血清蛋白、血清白蛋白和血红蛋白。分别在治疗前1天和治疗后28天通过饮水试验和对每位患者的吞咽障碍调查评估吞咽困难程度。记录胃肠道出血、吸入性肺炎和反流性食管炎等不良事件。治疗28天后,对照组和PEG组的体重、总血清蛋白、血清白蛋白和血红蛋白均较治疗前增加(P<0.05),且PEG组的增加更为显著(P<0.05)。同时,PEG组的吞咽功能改善更为显著(P<0.05),不良事件发生率低于对照组(P<0.05)。吞咽障碍综合训练方法联合肠内PEG营养对创伤性脑损伤后吞咽障碍儿童有确切疗效。