摘要
目的探讨内镜下经皮胃造瘘术在危重症患者的应用策略和疗效。方法选择收治的行胃造瘘术的危重症患者66例,其中内镜下经皮胃造瘘术32例,作为研究组,传统胃造瘘术34例作为对照组。比较两组在麻醉方式、手术时间、管饲起始时间、手术前后患者一般指标改变,术后并发症、住院时间等情况。结果①两组患者均顺利完成手术,无死亡病例,研究组患者在胃镜室局部麻醉下完成,对照组患者在手术室下行气管内插管全麻完成。②研究组手术时间、管饲起始时间明显低于对照组,两组差异有统计学意义(P<0.01)。③两组患者手术1个月后体重、血红蛋白、白蛋白较手术前均明显提高(P<0.05),两组比较无统计学差异(P>0.05)。④两组患者术后并发症发生率、住院时间无统计学差异(P>0.05)。结论内镜下经皮胃造瘘术操作时间短,管饲起始时间快,可在胃镜室局部麻醉下完成,疗效及并发症发生率均与传统胃造痿术相似,值得临床推广应用。
Objective To explore the strategy and efficacy of endoscopic percutaneous gastrostomy used in critical patients.Methods A total of 66 critical patients were randomly allocated in this study,32 cases used endoscopic percutaneous gastrostomy were allocated in study group,and 34 patients with conventional gastrostomy were allocated in control group.Anesthesia,operating time,the duration for tubal feeding,the changes in general indicators before and after operation,postoperative complications and duration of hospitalization were compared between these two groups.Results ① Patients in these two groups were successfully completed with operation,without death.The operation in patients of study group had been completed in the gastroscopy room under local anesthesia,and the operation in patients of control group completed in the operating room under endotracheal intubation.②The operating time,duration for tubal feeding was significantly shorter than that of control group,and the difference in these two groups was statistically significant（P 0.01）.③ Body weight,blood levels of hemoglobin and albumin in patients of these 2 groups were compared with those before operation,and they were significantly increased（P 0.05） between these two sets of data,there was no statistically significant difference（P 0.05）.④ The difference in incidence of postoperative complications and length of stay between these 2 groups was not significant（P 0.05）.Conclusion Endoscopic percutaneous gastrostomy has shorter operating time and duration for tubal feeding,it can be completed in the gastroscopy room under local anesthesia,and postoperative complications are low,hence it is worthy to be recommended for clinical application.
出处
《临床和实验医学杂志》
2013年第15期1211-1213,共3页
Journal of Clinical and Experimental Medicine
关键词
经皮胃造瘘术
胃镜
危重症
外科造瘘
Gastrostomy percutaneous stomach
Gastroscopy
Critically ill patients
Surgical fistula
