经皮内镜胃造瘘和小肠造瘘术的临床应用价值

Clinical Value of Percutaneous Endoscopic Gastrostomy and Percutaneous Endoscopic Jejunostomy

目的 探讨经皮内镜胃造瘘术（percutaneous endoscopic gastrotomy，PEG）和经皮内镜小肠造瘘术（percutaneous endoscopic jejunostomy，PEJ）的临床应用价值。方法 1996年6月～2006年4月行PEG胃肠营养97例；行PEG胃肠减压加PEJ小肠内营养34例。结果 131例共行PEG、PEG加PEJ146例次，其中PEG112例次（15例行造瘘管置换）、PEG加PEJ34例次，手术成功率100％。5例患者出现造瘘管周围皮下感染。所有患者造瘘管置入后营养迅速恢复，停止静脉补液。131例平均随访10个月无严重并发症发生。结论 PEG和PEJ作为胃肠减压和肠内营养替代鼻饲的一种新的治疗方法，具有安全、降低医疗费用和并发症少的优点，如有条件，应当选用。

Objective To study the clinical value of percutaneous endoscopic gastrostomy （PEG） and percutaneous endoscopic jejunostomy （PEJ）. Methods 97 patients underwent PEG and 34 patients underwent PEG plus PEJ from June 1996 to April 2006. Results All the 131 patients received 146 times of PEG or PEG plus PEJ. The tubes of 15 patients who were treated with PEG were replaced for malfunction. All cases were succeeded. Subcutaneous infection around the tube occurred in 5 patients. Nutritional status were progressively improved and subsequently led to the withdrawal of total parenteral neutrition. Conclusions PEG and PEJ are safe, low-cost new methods for gastrointestinal decompression and enteral nutrition, presenting as a approach to replace the nasogastric tube feeding.