经皮内镜下胃造瘘术在吞咽困难病人中的应用

Application of Percutaneous Endoscopic Gastrostomy in Patients with Dysphagia

目的:探讨经皮下内镜下胃造瘘术(PEG)在吞咽困难、需要肠内营养支持患者中的应用价值。方法:选择12例不能忍受鼻胃管机械刺激、或置鼻胃管后痰多和胃内容物返流出现难治性肺炎的患者作PEG。结果:12例PEG术成功,均无严重并发症,仅2例出现局部皮肤轻度炎症,术后鼻胃管对鼻腔、咽部、食道粘膜的刺激作用如疼痛、出血、鼻塞、恶心、呕吐消失,分泌物减少,胃内容物返流停止,肺部感染减轻或消失,患者的神经功能缺损改善。结论:PEG术安全、有效、可行,很多方面优于鼻胃管。

ObjectiveiTo investigate and discuss the application values of percutaneous endoscopic gastrostomy (PEG) in patients with dysphagia who should be supported with anteral nutrition. Methods:PEG was performed on 12 selected patients who could not bear the mechanical irritation of nasogastric tube or suffered from refractory lung infection partly due to increased sputa and gastric contents reflux after placement of nasogastric tube. Results:PEG was successed in all patients, only 2 cases developed superficial infection of skin around the catheter and there were no other major complication in all patients, after PEG, the side effectives of mechanical irritation of mucous membrane on nasal cavitas, pharynx and esophagus during placement of nasogastric tube such as pain, nasal blockage, nause, vomiting and bleeding disappeared, refrectory lung infection were gradually controled after reduction of sputa and stop of gastric contents reflux, and nerve function of all patients were improved. Conclusions:PEG was safe,effective,feasible,and had advantages over nasogastric tube in many aspects.