摘要
目的总结经皮内窥镜引导下胃/肠造口的经验,探讨内窥镜置管的技术操作及其适应证、禁忌证和并发症。方法回顾性分析了2001年7月～2007年12月在我院成功实施经皮内窥镜引导下胃/肠造口术的578例患者的临床资料,观察了置管的种类、目的、时间、成功率、并发症及留置时间。结果578例患者中,经皮内窥镜引导下胃造口(PEG)247例,经皮内窥镜引导下胃空肠造口(PEGJ)293例,经皮内窥镜引导下十二指肠造口(PED)4例,直接法经皮内窥镜引导下空肠造口(DPEJ)4例,经皮内窥镜引导下结肠造口(PEC)4例,PEG/J联合食管支架26例。其中,肠内营养329例,减压同时联合肠内营养133例,胃肠减压103例,肠内营养联合胆汁回输5例,围手术期应用4例,顺行灌肠4例。PEG平均操作时间为(7.5±1.9)min,PEGJ为(17.7±4.2)min,DPEJ为(14.8±2.1)min,PED为(12.3±2.5)min,PEC为(11.3±2.6)min,PEG/J联合支架为(30.2±5.2)min。技术成功率为98.0%(578/590),严重并发症发生率1.04%(6/578),轻微并发症发生率6.23%(36/578),平均留置时间(168.37±198.64)d。结论经皮内窥镜引导下胃/肠造口术操作简便、有效、并发症少,易于护理、患者耐受良好、易于接受、可长期带管,适用于肠内营养支持、胃肠减压、胆汁回输、围手术期应用等。
Objective To summarize the clinical experiences in percutaneous endoscopic gastrostomy （PEG） / percutaneous endoscopic jejunostomy （ PEJ）. Methods We retrospectively analyzed the clinical data of 578 patients who received either PEG or PEJ from July 2001 to December 2007 in our hospital. The data analyzed included the type, aim, duration, success rate, and complications of these procedures. Results Of 578 patients, 247 patients underwent PEG, 293 patients underwent percutaneous endoscopic gastrojejunostomy （PEG J） , 4 patients received percutaneous endoscopic duodenostomy （PED） , 4 patients underwent direct percutaneous endoscopic jejunostomy （DPEJ） , 4 patients underwent percutaneous endoscopic colostomy （PEC） , and 26 patients received PEG/J combined stents. These procedures were performed in different clinical conditions, including enteral nutrition （ n = 329） , decompression combined enteral nutrition （ n = 133 ） , decompression of the gastrointestinal tract （ n = 103 ） , enteral nutrition combined bile refeeding （ n = 5 ） , perioperative applications （ n = 4） , and coloclysis （ n = 4） . Tubes were successfully placed in 578 patients （98.0%） in an average time of （7.5 ±1.9） minin PEG, （17.7±4.2） minin PEGJ, （14.8 ±2.1） min in DPEJ, （12.3 ±2.5） mininPED, （11.3±2.6） min in PEC, and （30.2 ±5.2） min in PEG/J combined stent, respectively. No procedure-related complications were observed. Major complications were found in 6 patients （ 1.04% ） and minor complications in 36 patients （6.23%）. The duration of tube functioning was （ 168.37 ± 198.64） d. Conclusions PEG/PEJ are easy to handle, effective, safe, and convenient for nursing. The endoscopic method of tube placement can be performed at the bedside and allow for enteral feeding, gastrointestinal decompression, and internal biliary drainage to be rapidly and efficiently achieved.
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2008年第3期249-252,共4页
Acta Academiae Medicinae Sinicae
