经皮内镜下胃造口、空肠造口及十二指肠造口120例临床分析  

Clinical experience of percutaneous endoscopic gastrostomy, jejunostomy,duodenostomy in 120 patients

作　　者：江志伟[1] 汪志明[1] 黎介寿[1] 李宁[1] 吴素梅[1] 丁凯[1] 刘碧竹[1] 黄琦[1] 李强[1] 贾云鹤[1] 周伟[1] 

机构地区：[1]南京军区南京总医院全军普通外科研究所,210002

出　　处：《中华外科杂志》2005年第1期18-20,共3页Chinese Journal of Surgery

摘　　要：目的　探讨经皮内镜下胃造口、空肠造口及十二指肠造口的技术操作及适应证。方法2 0 0 1年 5月— 2 0 0 4年 4月间 ,共行 12 0例经皮内镜下胃肠造口 ,其中 75例经皮内镜下胃造口 (PEG) ,4 2例经皮内镜下空肠造口 (PEJ) ,2例经皮内镜下十二指肠造口 (PED) ,1例直接法经皮内镜下空肠造口(DPEJ)。操作均采用经典经腹壁拉出法技术。结果　采用上述方法共行长期肠内营养 88例 ;胃肠减压 2 5例 ;肠内营养联合胆汁回输 5例 ;围手术期应用PEG 2例 ,术前行胃肠减压 ,术后行长期肠内营养。PEG操作时间平均 (9± 4 )min ,PEJ平均 (17± 6 )min ,DPEJ为 2 0min ,2例PED分别为 10和 12min。技术成功率 98 4 % (12 0 / 12 2 )。严重并发症发生率为 0 8% (1/ 12 0 ) ,轻微并发症发生率为 7 5 %(9/ 12 0 )。结论　经皮内镜下胃肠造口操作简便、有效 ,并发症少。Objective To report clinical experience of percutaneous endoscopic gastrostomy, duodenostomy, jejunostomy in 120 patients, focusing on its technique and indications. Methods One hundred and twenty patients received percutaneous endoscopic gastrostomy, duodenostomy, jejunostomy from May 2001 to April 2004, including 75 percutaneous endoscopic gastrostomy (PEG), 42 percutaneous endoscopic jejunostomy (PEJ), 2 percutaneous endoscopic duodenostomy (PED), 1 direct percutaneous endoscopic jejunostomy (DPEJ). All tubes established by traditional pull technique.Results The average duration of PEG was (9±4) min,PEJ (17±6) min,DPEJ 20 min,and PED was 10 and 12 min for 2 patients,respectively. Success rate of the technique was 98 4%(120/122). Major complication rate was 0 8%(1/120), and minor complication rate was 7 5%(9/120). Clinical indications: PEG, PED and PEJ were applied for long term enteral nutritional support in 88 patients, gastrointestinal decompression in 25 patients, and transfusing external drainage bile to gastrointestinal tract in 5 patients. Two radiation enteritis patients used PEG for gastrointestinal decompression preoperatively and long term enteral nutritional support postoperatively.Conclusion PEG,PED PEJ and DPEJ are easily handled, effective and safe , and may be widely used in clinical practice.

关 键 词：经皮内镜 空肠造口 十二指肠 肠内营养 PEJ 胃肠减压 并发症 PEG 成功率 

分 类 号：R656[医药卫生—外科学] R459.3[医药卫生—临床医学]