Olson D L, Krubsack A J, Stewart E T
Department of Radiology, Clement Zablocki Veterans Administration Medical Center, Milwaukee, WI.
Radiology. 1993 Apr;187(1):105-8. doi: 10.1148/radiology.187.1.8451395.
Scintigraphy was used to detect gastroesophageal reflux, determine whether percutaneous gastrostomy (PG) tubes cause reflux, and help in the choice between PG tubes versus percutaneous gastrojejunostomy (PGJ) tubes. During a 2-year period, 46 patients were evaluated with scintigraphy immediately before and 1 week after PG tube placement. Findings in the pre- and postplacement reflux studies were the same in 39 patients (85%). Proof of reflux on either study was considered an indication for conversion to the PGJ tube; at least one study was positive for reflux in 21 patients (46%). All patients were followed up for tube complications, pneumonia, and cause of death. During follow-up, six of 24 patients correctly maintained with PG tubes (25%) and 18 patients with PGJ tubes (39%) developed pneumonia, the cause of death in four of 24 patients with PG tubes (17%) and five of 18 patients with PGJ tubes (28%). The PG tube does not induce reflux, and scintigraphy is useful in selection of patients who can be safely maintained with the PG tube without an increase in the morbidity or mortality associated with reflux and aspiration.
闪烁扫描术用于检测胃食管反流、确定经皮胃造口术（PG）管是否会引起反流，并辅助在PG管和经皮胃空肠造口术（PGJ）管之间做出选择。在两年期间，对46例患者在放置PG管之前及之后1周立即进行闪烁扫描术评估。39例患者（85%）放置前后的反流研究结果相同。两项研究中任何一项出现反流证据均被视为转换为PGJ管的指征；21例患者（46%）至少有一项研究显示反流呈阳性。对所有患者随访观察导管并发症、肺炎及死亡原因。随访期间，24例正确留置PG管的患者中有6例（25%）发生肺炎，18例留置PGJ管的患者中有18例（39%）发生肺炎；24例留置PG管的患者中有4例（17%）死亡，18例留置PGJ管的患者中有5例（28%）死亡。PG管不会诱发反流，闪烁扫描术有助于选择能够安全留置PG管而不会增加与反流和误吸相关的发病率或死亡率的患者。
