经皮内镜下胃造口术在脑卒中患者康复期的应用

The application of percutaneous endoscopic gastrostomy in patients with cerebral apoplexy for rehabilitation

目的总结经皮内镜下胃造口术(PEG)应用于25例脑卒中伴意识障碍患者康复期的经验。方法 在静脉麻醉及心电监测下,对25例脑卒中伴意识障碍康复期的患者行PEG,加强围手术期处理,特别注意相关肺部感染的治疗及观察。结果 PEG成功率100%、操作时间平均(10±3)min;无手术相关死亡、出血、腹膜炎等并发症,术中及术毕时发生2例心肺并发症,经及时治疗后好转;术后随访6～18月,术后肺部感染得到有效控制。结论 对脑卒中伴意识障碍康复期的患者行PEG治疗是安全的,它有利于肺部感染的控制,但需加强围手术期处理。

Objective To summarize the application of percutaneous endoscopic gastrostomy（PEG） in 25 patients with cerebral apoplexy and consciousness obstacle for rehabilitation.Methods Under intravenous anesthesia and ECG monitoring,25 patients with cerebral apoplexy and consciousness obstacle at rehabilitation received PEG,the perioperative management was strengthened,especially on the observation and treatment of lung infection.Results The successful rate of PGE was 100%,operating time was（10±3） min on average;No operative death,bleeding,abdominal associated complications occurred,such as the abdomen inflammation,both preoperative and perioperative.Although 2 cases had cardiopulmonary complications reoccurred,after prompt treatment the symptoms were improved immediately.Patients were further followed up from 6 to 18 months,and postoperative lung infection was controlled effectively.Conclusion PEG is a safe operation for patients with cerebral apoplexy and consciousness obstacle at rehabilitation,which can help to control lung infection,but the strengthening of perioperative management is still needed.