经皮内镜下胃和空肠造口术在临床中的应用  

The use of percutaneous endoscopic gastrostomy and percutaneous endoscopic jejunostomy in enteral nutrition

作　　者：欧希龙[1] 刘松桥[2] 邱海波[2] 孙为豪[3] 曹大中[1] 俞谦[1] 张有珍[1] 吴自英[1] 刘顺英[1] 

机构地区：[1]东南大学附属中大医院消化科,江苏南京210009 [2]东南大学附属中大医院ICU,江苏南京210009 [3]南京医科大学附属第一医院老年医学科,江苏南京210029

出　　处：《肠外与肠内营养》2009年第6期358-360,共3页Parenteral & Enteral Nutrition

摘　　要：目的:探讨经皮内镜下胃和空肠造口术的方法。方法:114例病人胃造口术(PEG)采用Pull法,26例空肠造口术(PEJ),在PEG基础上用异物钳钳夹胃腔内空肠造口管,推送胃镜将其送至Treitz韧带以下。结果:PEG成功率为100%,通过改良胃镜下直接置管方法,26例PEJ全部一次放置成功。15例局部有活动性出血,8例局部有分泌物和红肿,经相应处理后缓解。21例引起呼吸道感染,用抗生素治愈,1例胃黏膜下出血,形成血肿,1例在第8天发现胃造口内固定片嵌顿,未出现严重并发症。结论:PEG简单、安全、可行;PEJ方法可一次使造口管到达空肠,有临床应用价值。Objective： To establish the method of percutaneous endoscopic gastrostomy（PEG） and percutaneous endoscopic jejunostomy （PEJ） for enteral nutrition. Methodes： PEG tubes were placed in 114 patients with Pull method. On the foundation of PEG, PEJ tubes were placed in 26 patients by pushing endoscopy to send tubes through Treitz ligment with usingthe the clip. Results： All PEG insertion was performed successfully. PEJ tubes were placed successfully with a new method in 26 patients. 15 patients had a little blooding and 8 patients had slight infection. 21 patients had respiratory tract infection and had been cured by using antibiotic. There was no severe complication. Conclusion： PEG is simple,safe,efficient. The new method of PEJ is feasible.

关 键 词：胃镜 胃造口术 空肠造口术 肠内营养支持 置管方法 

分 类 号：R459.3[医药卫生—治疗学]