经皮内镜下胃造瘘术在合并吞咽困难危重患者中的应用

摘要

Objective To evaluate safety of applying the percutaneous endoscopic gastrostomy (PEG) for critical patients with deglutition disorders. Methods Twenty-three patients were involved in this study who met the criteria of critical patients with deglutition disorders accepted PEG in ICU of Chongqing Sanxia Central Hospital. Results The operation time were 10~25 min. 22 cases obtained satisfactory outcome, 1 case presented cardiovascu-lar responses and suspended operation (volume of bleeding was about 15~25 ml), and 2 cases presented reflux and as-piration pneumonia, 5 cases presented parastomal skin infection, 1 case presented stomach contents leakage, 2 cases presented catheter occlusion/shedding. 9 cases died of primary disease exacerbation. The longest duration of the tube stay was 10 months, and the shortest duration of the tube stay was 2 months. Conclusion PEG provides an economic reliable, gastrointestina nutritional approach for critical patients with deglutition disorders.%目的：评价经皮内镜下胃造瘘术(PEG)在合并吞咽困难危重患者中应用的安全性。方法收集重庆市三峡中心医院ICU收治的23例合并吞咽困难并行PEG危重患者的临床资料，记录其术中情况及术后并发症。结果手术时间均在10~25 min，其中22例一次成功，1例因心血管反应中止手术，出血量15~25 ml，术后并发返流性/吸入性肺炎2例，造瘘口旁皮肤感染5例，胃内容物漏出1例；导管堵塞/脱落2例。9例因原发病加重死亡，造瘘口管最长留置时间10个月，最短留置时间2个月。结论合并吞咽困难的危重患者，PEG提供了一个可靠，经济的胃肠营养途径。