Wijdicks E F, McMahon M M
Department of Neurology, Critical Care Neurology, Metabolism and Nutrition and Internal Medicine, Mayo Clinic and Mayo Medical Center, Saint Marys Hospital, Rochester, Minn. 55905, USA.
Cerebrovasc Dis. 1999 Mar-Apr;9(2):109-11. doi: 10.1159/000015907.
To review the complications and outcome of percutaneous endoscopic gastrostomy placement (PEG) in 74 patients with acute stroke.
Medical record review and follow-up of patients with acute stroke admitted to a referral center.
There were no immediate procedure-related complications. Late complications included aspiration pneumonia (11%), PEG occlusion and replacement (6%), accidental PEG removal (6%), wound infection (3%) and fatal gastrointestinal bleeding in 1 patient. In 18 patients (28%), PEG could be subsequently removed due to improvement in swallowing.
PEG provides an effective alternative method of enteral feeding, but its impact on outcome remains uncertain. Late complications occurred in one third of the patients, but were seldom life threatening. Removal of the gastrostomy tube and resumption of oral feeding was possible in more than a quarter of the patients. All our patients who received PEG placement after acute stroke remained severely disabled; one third of the patients died from systemic complications of their stroke.
回顾74例急性脑卒中患者行经皮内镜下胃造口术（PEG）的并发症及结局。
对转诊中心收治的急性脑卒中患者进行病历回顾及随访。
术中无即刻相关并发症。晚期并发症包括吸入性肺炎（11%）、PEG堵塞及更换（6%）、PEG意外拔除（6%）、伤口感染（3%），1例患者发生致命性消化道出血。18例患者（28%）因吞咽功能改善随后拔除了PEG。
PEG是一种有效的肠内营养替代方法，但其对结局的影响仍不确定。三分之一的患者出现晚期并发症，但很少危及生命。超过四分之一的患者可以拔除胃造口管并恢复经口进食。所有急性脑卒中后接受PEG置管的患者仍严重残疾；三分之一的患者死于脑卒中的全身并发症。
