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经皮内镜下胃造口术:长期随访

Percutaneous endoscopic gastrostomy: a long-term follow-up.

作者信息

Finocchiaro C, Galletti R, Rovera G, Ferrari A, Todros L, Vuolo A, Balzola F

机构信息

Department of Gastroenterology and Clinical Nutrition, Molinette Hospital, Turin, Italy.

出版信息

Nutrition. 1997 Jun;13(6):520-3. doi: 10.1016/s0899-9007(97)00030-0.

Abstract

Percutaneous endoscopic gastrostomy (PEG) is the preferred method of long-term tube feeding, but only a few studies describe a long-term follow-up. The purpose of this study is to analyze the follow-up of PEG enteral feeding patients in the long term, and to report on the complication and survival rates. Between January 1991 and June 1995, we studied 136 patients (49% cancer and 51% non-cancer patients; male = 68%, female = 32%) after PEG insertion. One hundred twenty-eight patients had a long-term follow-up of over 31 d. The mean duration of PEG feeding was 277 +/- 358 d (range 31-1590): 17% of patients returned to oral feeding, 34% continued enteral nutrition, and 49% died. Major complications occurred in 3% of the patients: 1 aspiration pneumonia, 1 subcutaneous abscess. 2 buried bumper syndrome. Minor complications arose in 14% of our cases: 8 tube blockages, 4 tube dislodgements, 6 site infections. For the whole group of 136 patients, survival probabilities after PEG insertion at 1, 6, 12, and 24 mo were 90.5%, 52%, 42%, and 35%, respectively. After 180 d, the difference in survival probabilities between cancer and non-cancer patients became significant (P < 0.02). Median survival probability was 64% for non-cancer and 39% for cancer patients, and this trend did not change over 2 y.

摘要

经皮内镜下胃造口术(PEG)是长期管饲的首选方法,但仅有少数研究描述了长期随访情况。本研究的目的是长期分析PEG肠内喂养患者的随访情况,并报告并发症和生存率。1991年1月至1995年6月,我们对136例行PEG置入术的患者进行了研究(49%为癌症患者,51%为非癌症患者;男性占68%,女性占32%)。128例患者进行了超过31天的长期随访。PEG喂养的平均持续时间为277±358天(范围31 - 1590天):17%的患者恢复经口喂养,34%的患者继续肠内营养,49%的患者死亡。3%的患者发生了严重并发症:1例吸入性肺炎,1例皮下脓肿,2例埋入式胃造口管综合征。14%的病例出现了轻微并发症:8例管道堵塞,4例管道移位,6例造口部位感染。对于136例患者的整个队列,PEG置入术后1、6、12和24个月的生存概率分别为90.5%、52%、42%和35%。180天后,癌症患者和非癌症患者的生存概率差异变得显著(P < 0.02)。非癌症患者的中位生存概率为64%,癌症患者为39%,且这种趋势在2年内未改变。

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