CT引导下和内镜下经皮胃造瘘术对肌萎缩侧索硬化患者的疗效观察  

Clinical observation of CT-guided and endoscopic percutaneous gastrostomy in patients with amyotrophic lateral sclerosis

作　　者：廉羚 林伟源 向贤宏[2] 姚晓黎[1] LIAN Ling;LIN Weiyuan;XIANG Xianhong;YAO Xiaoli(Department of Neurology,the First Affiliated Hospital,Sun Yat-Sen University/Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases,National Key Clinical Department and Key Discipline of Neurology,Guangzhou 510080,China;Department of Interventional Radiology,the First Affiliated Hospital,Sun Yat-Sen University)

机构地区：[1]中山大学附属第一医院神经科,广东省重大神经疾病诊治研究重点实验室,国家临床重点专科和国家重点学科,510080 [2]中山大学附属第一医院放射介入科

出　　处：《天津医药》2023年第7期687-690,共4页Tianjin Medical Journal

基　　金：国家自然科学基金面上项目(82271448);广州市科技计划项目(SL2022A04J01813);广东省重大神经疾病诊治研究重点实验室(2020B1212060017);广东省神经系统疾病临床医学研究中心项目(2020B1111170002);华南神经疾病早期干预及功能修复研究国际联合研究中心项目(2015B050501003,2020A0505020004);广东省神经系统重大疾病诊治工程技术研究中心、广东省神经系统重大疾病诊治转化医学创新平台和广州市神经系统重大疾病临床医学研究与转化中心项目(201604020010)。

摘　　要：目的比较CT引导下和内镜下经皮胃造瘘术在肌萎缩侧索硬化(ALS)患者中的临床应用效果。方法104例ALS患者中48例行CT引导下经皮胃造瘘术(CT引导组),56例行内镜下经皮胃造瘘术(内镜组)。比较2组患者的疾病情况、住院时间、术后住院时间、术后并发症情况以及术后半年及1年生存率。结果2组患者年龄、病程、吞咽困难时间、身高、体质量、术前营养状况差异无统计学意义(P>0.05)。CT引导组患者住院时间和术后住院时间较内镜组缩短(P<0.05)。内镜组并发症发生率(19.6%)和CT引导组(8.3%)比较差异无统计学意义(P>0.05)。内镜组与CT引导组术后1年生存率差异均无统计学意义(91.0%vs.93.8%,Log-rank χ^(2)=1.606,P>0.05)。结论CT引导下经皮胃造瘘术在缩短ALS患者住院时间及术后住院时间方面具有明显优势,值得临床广泛推广。Objective To compare the clinical effects of CT-guided and endoscopic surgical percutaneous gastrostomy in patients with amyotrophic lateral sclerosis(ALS).Methods The clinical data of 104 patients with ALS were retrospectively analyzed,including 48 patients underwent CT-guided percutaneous gastrostomy(CT-guided group)and 56 patients underwent endoscopic percutaneous gastrostomy(endoscopic group).The disease status,length of hospital stay,postoperative length of hospital stay,postoperative complications,and survival rates of six months and one year after surgery were compared between the two groups.Results There were no significant differences in age,disease course,dysphagia time,height,body weight and preoperative nutritional status between the two groups(P>0.05).The length of hospital stay and postoperative length of stay were shorter in the CT-guided group than those in the endoscopic group(P<0.05).There was no significant difference in the incidence of complications between the endoscopic group(19.6%)and the CT-guided group(8.3%,P>0.05).There was no significant difference in one-year survival rate between the endoscopic group and the CT-guided group(91.0%vs.93.8%,Log-rank χ^(2)=1.606,P>0.05).Conclusion CT-guided percutaneous gastrostomy shows its advantages in ALS,especially in shortening the length of hospital stay and postoperative length of hospital stay in ALS patients,and is worthy of widespread clinical application.

关 键 词：肌萎缩侧索硬化 经皮胃造瘘 吞咽困难 并发症 住院时间 

分 类 号：R746.4[医药卫生—神经病学与精神病学]