经皮内镜下胃造口术在家庭肠内营养治疗中的应用研究  

The research of percutaneous endoscopic gastrostomy application in the home enteral nutrition support

作　　者：胡珊珊 宋彦 徐俐 罗玉明 赵海明 李咏芳 张俊芳 

机构地区：[1]四川省医学科学院.四川省人民医院城东病区消化内科,四川成都610110

出　　处：《临床消化病杂志》2018年第1期19-23,共5页Chinese Journal of Clinical Gastroenterology

基　　金：四川省卫生厅科研资助项目(No:100541;110212)

摘　　要：[目的]探索经皮内镜下胃造口术(PEG)在家庭肠内营养(HEN)治疗中的安全管理方法,评估其临床应用价值。[方法]采取HEN综合管理措施,回顾分析158例需要带管出院实施HEN治疗患者的临床资料,分析HEN治疗过程中,PEG管理的可操作性、营养制剂种类、使用时间、营养评估及并发症处理。158例中出血性脑卒中49例,脑梗死19例,重型颅脑损伤78例,克罗恩病12例。[结果]实施HEN治疗后第30、60和90天,患者的体质量、上臂肌围、体质指数、血红蛋白、血清白蛋白等指标均明显高于治疗前,差异有统计学意义(P<0.01)。并发症统计有3例发生胃内容物潴留,2例胃内容物反流,3例吸入性肺炎,1例PEG内垫脱落。[结论]HEN治疗具有管理简单、操作可行、安全性高、并发症少等优点,对长期不能经口进食的营养不良患者在HEN中有显著治疗作用,可避免患者营养状况进一步恶化,提高患者生活质量,值得临床推广。[Objective]To evaluate the safety and efficacy of percutaneous endoscopic gastrostomy（PEG） in home enterol nutrition support. [Methods]We retrospectively analyzed the clinical data of the 158 patients, including hemorrhagic stroke （n = 49 ）, cerebral infarction （n = 19 ）, severe brain injury （ n =78 ）, Crohn＇s disease（n=12）. All these patients underwent PEG in our hospital for the inability of orally food intake. [Results]The weight, mid arm muscle circumference, body mass index, hemoglobin, serum albumin on the 30 th,60 th,and 90 th days after the treatment were significantly higher than those before the treatment （P〈0.01）. Complications included gastric contents retention（n =3）, back streaming （n =2 ）, aspirated pneumonia（n =3）, and intra-cushion shedding（n =1）. [Conclusion] The advantages of percutaneous endoscopy gastrostomy （PEG） in the treatment of home enteral nutrition （HEN） management is simple, feasible operation,high safety and less complications. It can benefit the malnutrition patients with long-term food intake dysfunction and avoid further deterioration in the nutritional status, improve the quality of life of patients. It is worthy of clinical technology in HEN.

关 键 词：经皮内窥镜引导下胃造口术 家庭肠内营养 营养不良 

分 类 号：R730.49[医药卫生—肿瘤]