Martín A, Espinós J C, Forné M, Rius J, Corbera G, Quintana S, Viver J M
Servicios de Digestivo, Medicina Interna, Hospital de Mútua de Terrassa, Barcelona.
Med Clin (Barc). 1994 Oct 15;103(12):449-51.
A review of the technique, indications, complications and follow up of percutaneous endoscopic gastrostomy (PEG) was performed.
Thirty-five patients in whom a PEG had been placed according to the Ponsky technique from 1991 to 1993 were analyzed 27 of whom had neurologic disease, 6 tumoral diseases and 2 other causes.
PEG was carried out in 33 patients with no incidences while the technique could not be performed in 2 since the point could not be identified by transillumination in the gastric wall. No immediate complications were observed. Seven minor early complications were presented as wound infection with the cannula being withdrawn in only one case due to persistence of the infection. Five late complications were reported: 1 severe (gastrocholic fistula) and 4 minor (2 cannula obstructions, 1 displacement and 1 infection). Evolution was followed in 31 patients with the cannula being withdrawn in 4 (2 because of complications and in the other 2 on initiation of oral diet). The cannula was substituted at 120 and 360 days in 2 patients. Sixteen patients died, 5 during the first 30 days due to the primary disease, with only one case (aspirative pneumonia) being related to the PEG. The PEG continues functioning in 11 patients.
Percutaneous endoscopic gastrostomy for feeding is a simple technique which may be carried out in most patients with scarce severe complications, allowing a good nutritional state and improving the quality of life of patients requiring prolonged enteral feeding.
对经皮内镜下胃造口术(PEG)的技术、适应证、并发症及随访情况进行了综述。
分析了1991年至1993年期间根据庞斯基技术进行PEG置管的35例患者,其中27例患有神经系统疾病,6例患有肿瘤疾病,2例因其他原因。
33例患者成功进行了PEG置管,无手术失败情况;2例因无法通过胃壁透照定位而未能实施该技术。未观察到即刻并发症。出现7例轻度早期并发症,表现为伤口感染,仅1例因感染持续而拔除套管。报告了5例晚期并发症:1例严重并发症(胆胃瘘)和4例轻度并发症(2例套管阻塞、1例移位和1例感染)。对31例患者进行了随访,4例拔除了套管(2例因并发症,另外2例在开始经口饮食时拔除)。2例患者分别在120天和360天时更换了套管。16例患者死亡,5例在最初30天内死于原发病,仅1例(吸入性肺炎)与PEG相关。11例患者的PEG仍在发挥作用。
经皮内镜下胃造口术用于喂养是一种简单的技术,大多数患者实施该技术时严重并发症较少,可维持良好的营养状态,提高需要长期肠内喂养患者的生活质量。