改良经皮内镜下胃造瘘术在肌萎缩侧索硬化症患者中的应用  

Application of Modified Percutaneous Endoscopic Gastrostomy in Patients With Amyotrophic Lateral Sclerosis

作　　者：刘文正[1] 马玉环 常虹[1] 闫秀娥 姚炜[1] 王迎春[1] 郑炜[1] 张耀朋[1] 黄永辉[1] Liu Wenzheng;Ma Yuhuan;Chang Hong(Department of Gastroenterology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院消化科,北京100191 [2]北京清华长庚医院消化科,北京102218

出　　处：《中国微创外科杂志》2025年第3期153-157,共5页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨改良经皮内镜下胃造瘘术(percutaneous endoscopic gastrostomy,PEG)对出现吞咽困难的肌萎缩侧索硬化症(amyotrophic lateral sclerosis,ALS)患者的应用价值。方法2018年1月~2023年12月我院对47例ALS行改良PEG,患者局部麻醉、半坐位,术者使用超细内镜经口入胃的方式实施手术。结果47例改良PEG均顺利完成,手术时间5~20 min,(10.3±1.7)min。术后住院2~8 d,平均2.8 d。术后并发症6例(12.8%),包括术后吸入性肺炎4例(8.5%),切口感染2例(4.3%)。PEG术前体重指数(Body Mass Index,BMI)17.06±0.89,术后3个月18.15±0.81,差异有显著性(t=-10.373,P=0.000)。结论对于出现吞咽困难的ALS患者,改PEG是可行的,能够明显改善患者的营养状况。Objective To evaluate the value of modified percutaneous endoscopic gastrostomy(PEG)for patients with amyotrophic lateral sclerosis(ALS)and dysphagia.Methods From January 2018 to December 2023,47 patients with ALS were treated with modified PEG in our hospital.The surgery was performed under local anesthesia.The patients were placed in a semi-seated position,and the surgeon performed surgery with an ultra-fine endoscope through oral entrance to the stomach.Results The modified PEG were successfully completed in all the 47 cases.The operation time was 5-20 min[mean,(10.3±1.7)min].The postoperative hospitalization lasted for 2-8 d(mean,2.8 d).Postoperative complications occurred in 6 cases(12.8%),including aspiration pneumonia in 4 cases(8.5%)and incision infection in 2 cases(4.3%).The body mass index was 17.06±0.89 before PEG and 18.15±0.81 at 3 months after PEG,with significant difference(t=-10.373,P=0.000).Conclusion For ALS patients with dysphagia,modified PEG is feasible,which significantly improves nutritional status of patients.

关 键 词：经皮内镜下胃造瘘术 肌萎缩侧索硬化症 体重指数 

分 类 号：R74[医药卫生—神经病学与精神病学]