经皮经胃镜胃造口对老年复发性吸入性肺炎的防治价值  

Application of percutaneous gastroscopy gastrostomy in the prevention and treatment of recurrent aspiration pneumonia in the elderly

作　　者：陈孝[1] 王志强[1] 张子其[1] 刘婧[1] 徐杰[1] 周庆[1] 王鸣[1] 张钰[1] Chen Xiao;Wang Zhiqiang;Zhang Ziqi(Division of Digestive Endoscopy,Department of Geriatrics Gastroenterology,The Second Medical Center&National Clinical Research Center for Geriatric Diseases,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第二医学中心消化内科内镜室,国家老年疾病临床研究中心,北京100853

出　　处：《中华保健医学杂志》2023年第1期20-23,共4页Chinese Journal of Health Care and Medicine

基　　金：军队保健专项课题重点项目(20BJZ43)。

摘　　要：目的 探讨经皮经胃镜胃造口对高龄老年复发性吸入性肺炎的防治效果。方法 回顾性选取解放军总医院第二医学中心2004年9月~2022年1月28例因误吸进行胃造口的复发性吸入性肺炎高龄住院患者,观察分析胃造口前后吸入性肺炎发生情况、治疗效果。结果 28例因误吸行胃造口术的复发性吸入性肺炎患者中,阿尔兹海默病、脑卒中、帕金森病等神经系统性疾病达89.28%,随访期间死于吸入性肺炎为82.61%。胃造口之前和之后,吸入性肺炎抗生素使用平均时间分别为31.95和43.83 d,两者差异无统计学意义(P> 0.05);但吸入性肺炎发生的平均间隔时间分别为50.04和110.62 d,差异具有统计学意义(P <0.05)。PEG-J和PEG胃造口方式吸入性肺炎发作时抗生素使用平均时间分别为39.48和47.56 d;发作间隔时间分别为108.64和112.32 d,差异均无统计学意义(P> 0.05)。结论 经皮经胃镜胃造口术对误吸、复发性吸入性肺炎具有一定的预防作用,胃造口之后管饲方式对误吸的影响尚不显著。Objective To investigate the effect of percutaneous endoscopic gastrostomy on recurrent aspiration pneumonia in the elderly.Methods From September 2004 to January 2022,28 elderly inpatients with recurrent aspiration pneumonia who underwent gastrostomy were retrospectively analyzed.The incidence and treatment effect of aspiration pneumonia before and after gastrostomy were analyzed.Results A mong the 28 patients with recurrent aspiration pneumonia who underwent gastrostomy due to aspiration,89.28%had neurological diseases such as Alzheimer's disease,stroke and Parkinson's disease,and 82.61%died of aspiration pneumonia during the follow-up period.Before and after gastrostomy,the average duration of antibiotic use in aspiration pneumonia was 31.95 days and 43.83 days,respectively.There was no significant difference between the two groups;But the average interval of aspiration pneumonia was 50.04 days and 110.62 days,respectively,with significant difference.After gastrostomy,the average time of antibiotic use was 39.48 days in PEG-J group and 47.56 days in PEG group due to aspiration pneumonia;The interval between attacks was 108.64 days and 112.32 days,respectively,with no significant difference.Conclusion Percutaneous endoscopic gastrostomy has a certain preventive effect on aspiration and recurrent aspiration pneumonia.After gastrostomy,the effect of different tube feeding methods on aspiration is not significant.

关 键 词：经皮经胃镜胃造口 老年人 吸入性肺炎 帕金森病 阿尔兹海默病 

分 类 号：R567[医药卫生—呼吸系统]