床旁无痛经皮内镜下胃造口术在80岁以上老年患者中应用的临床研究  

Clinical research of application of analgesia precutaneous endoscopic gastrostomy or jejunum through derma at bedside in aged patients

作　　者：黄方[1] 许德兵[2] 吴宁[1] 钱晓明[1] 

机构地区：[1]中国人民解放军南京军区南京总医院干部病房一科,江苏省南京市210002 [2]中国人民解放军南京军区南京总医院干部保健科,江苏省南京市210002

出　　处：《实用老年医学》2012年第3期224-226,共3页Practical Geriatrics

基　　金：南京军区科技创新资助项目(11MA097)

摘　　要：目的探讨床旁无痛经皮内镜下胃造口术(PEG)和(或)空肠造口术(PEJ)在>80岁老年患者中应用的安全性及临床价值。方法观察32例行鼻胃管灌食>6月的>80岁老年患者在静脉麻醉下行PEG(其中26例同时行空肠置管术PEJ)的并发症,比较术前术后患者舒适度、口鼻部、肺部感染的发生情况。结果平均置管时间为(14.10±3.26)min,置管成功率为100%,置管后并发造瘘口皮肤轻微感染5例,经换药后痊愈,未发生与置管有关的并发症;与术前比较,术后患者口鼻咽部舒适,口鼻部、肺部感染的发生率明显下降(P<0.05)。结论在>80岁老年患者中应用床边无痛PEG/PEJ便捷、安全、并发症少;增加患者舒适度、依存性,减少口鼻损伤、感染,肺部感染比例明显低于经鼻胃管肠内营养。Objective To investigate the salty and clinical value of prccutaneous endoscopic gastrostomy or jejunum （PEG/PEJ） applied at bedside in aged patients. Methods The complications of 32 cases of aged patients who underent PEG through nasogastric tube feeding under intravenous anesthesia were observed. 26 cases among of them underent PEJ at the same time. The comfort level, snout infection, pulmonary infection among the patients were analyzed before and after operation. Results The average time taken during placing tube was 14. 10 ± 3.26 min. The successful rate of plcing tube was 100 percent. 5 cases suffered from light skin infection after placing tube. The skin infections recovered after treatment. There were no complications associated with placing tube. The comfort level and the incidence of snout infection, pul- monary infection were descended obviously after operation （ P 〈 0. 05 ）. Conclusions The analgesia PEG/PEJ through derma at bedside in aged patients is a brief, safe, oligcomplication operation. The operation raises the degree of comfort and dependence of the patients, and decreases injury and infections of mouth and nose.

关 键 词：床旁无痛经皮内镜下胃和(或)空肠造口术 80岁以上老年人 安全性 肺部感染 

分 类 号：R459.3[医药卫生—治疗学]