Chait P G, Weinberg J, Connolly B L, Pencharz P, Richards H, Clift J E, Savoie S, Harrison D
Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.
Radiology. 1996 Dec;201(3):691-5. doi: 10.1148/radiology.201.3.8939217.
To evaluate a technique of retrograde insertion of gastrostomy and gastrojejunostomy tubes with radiologic guidance in children.
During a 4 1/2-year period, 511 patients underwent attempted insertion of gastrostomy or gastrojejunostomy tubes. Patients' ages ranged from premature to 18.6 years (mean age, 3.8 years), and weight range was 0.8-86.0 kg (mean weight, 12 kg). The charts of 453 patients were reviewed.
Placement was unsuccessful in six patients because of colonic interposition (n = 2), microgastria (n = 2), or hepatosplenomegaly (n = 2). Initial placement was a gastrostomy tube in 436 patients and a gastrojejunostomy tube in 69 patients. Sixty-eight gastrostomy tubes were converted to gastrojejunostomy tubes. Early complications (< 30 days) included skin infection (n = 11), stoma irritation (n = 20), and tube dislodgment (n = 6). Late complications included stoma irritation (n = 29), skin infection (n = 23), tube leakage (n = 14), and discomfort during feeding (n = 15). Two complications necessitated surgery: extragastric misplacement and small-bowel transgression. There were no tube-related deaths.
Percutaneous retrograde placement of gastrostomy or gastrojejunostomy tubes safely and effectively provides long-term nutrition for children. A team approach is essential to provide service to this cumulative population.
评估在放射学引导下对儿童进行胃造口术和胃空肠造口术管逆行插入的技术。
在4年半的时间里，511例患者尝试进行胃造口术或胃空肠造口术管插入。患者年龄从早产儿到18.6岁（平均年龄3.8岁），体重范围为0.8 - 86.0千克（平均体重12千克）。回顾了453例患者的病历。
6例患者置管失败，原因分别为结肠介入（2例）、小胃畸形（2例）或肝脾肿大（2例）。初始置管时，436例患者置入胃造口管，69例患者置入胃空肠造口管。68根胃造口管改为胃空肠造口管。早期并发症（<30天）包括皮肤感染（11例）、造口刺激（20例）和导管移位（6例）。晚期并发症包括造口刺激（29例）、皮肤感染（23例）、导管渗漏（14例）和喂食时不适（15例）。有2例并发症需要手术治疗：胃外误置和小肠穿孔。无与导管相关的死亡病例。
经皮逆行置入胃造口术或胃空肠造口术管能安全有效地为儿童提供长期营养。团队协作对于为这一累积患者群体提供服务至关重要。
