经皮内镜下胃造瘘术治疗脑梗死合并吞咽障碍患者的疗效观察

目的：观察经皮内镜下胃造瘘术（perutaneous endoscopic gastrotomy，PEG）治疗脑梗死合并吞咽障碍患者的临床疗效，并评估其临床应用价值及安全性。方法选取2012年2月-2013年1月湘潭市第三人民医院收治的23例脑梗死合并吞咽障碍患者，对其实施PEG，观察其临床疗效及并发症情况。结果成功实施PEG 23例，平均耗时（15.3±2.6）min。经造瘘管饲后，患者的营养状态明显改善。3例患者造瘘管局部出现红肿和脓性分泌物，1例患者造瘘管周围肉芽组织过度生长。除此之外未出现造瘘管脱出、坏死性筋膜炎、腹膜炎、胃肠穿孔及吸入性肺炎等严重并发症。结论经皮内镜下胃造瘘术对脑梗死合并吞咽障碍患者来说是一种安全有效的肠内营养方法。

Objective To observe Clinical efficacy and evaluate the clinical applications and safety of percutaneous endoscopic gastrostomy （PEG） in Cerebral patients with dysphagial. Methods 23 cases of patients with dysphagia has successfully implemented with PEG were retrospectively analyzed, and the clinic effect and the complication were observed. Results 23 cases were performed with PEG successfully, the average time was （15.3±2.6）min.The nutritional status of patients improved significantly after fistula feeding. Red swelling and purulent secretion occurred in 3 patients, the skin granulation hyperplasia in 1 patient. No severe complications happened such as prolapse of tube, necrotizing fasciitis, peritonitis, gastrointestinal perforation, aspiration pneumonia. Conclusion Percutaneous endoscopic gastrostomy is a safe and effective method of enteral nutrition for patients with dysphagia.