超细胃镜辅助Introducer法胃造瘘术的临床应用

发布时间：2018-05-02 11:29

本文选题：经皮内镜下胃造瘘术 + 超细胃镜　；参考：《中国内镜杂志》2017年10期

【摘要】：目的评估Introducer法经超细胃镜胃造瘘术(PEG)对吞咽障碍患者的临床应用效果及安全性。方法回顾性分析该院收治的22例吞咽障碍患者,6例患者采用普通胃镜完成胃造瘘术,16例患者因张口困难、咽喉部或食管重度狭窄不能通过普通胃镜者则使用超细胃镜经鼻或经口完成PEG,观察临床疗效及并发症情况。结果成功实施PEG 22例,其中2例鼻咽癌放疗术后张口困难、14例咽喉部及食管重度狭窄且普通胃镜不能通过者行经超细胃镜经鼻或经口完成胃造瘘术。普通胃镜PEG组和超细胃镜PEG组的操作平均时间分别为(12.2±2.9)和(11.8±3.2)min,但后者成功率更高、舒适性更好。有1例患者出现造瘘口感染,未出现出血、食管和胃肠穿孔、包埋综合征等并发症。预防性PEG为17例鼻咽癌和食管癌患者辅助同步放化疗,完成率达100.0%;对放疗前后营养指标(血红蛋白、白蛋白、红细胞计数)进行配对t检验,造瘘后营养状况改善,差异有统计学意义(P0.05)。结论 Introducer法经超细胃镜胃造瘘术是一种更加安全有效的肠内营养方法,尤其适用于各种原因所致张口困难、咽喉部或食管重度狭窄患者。预防性PEG有助于晚期鼻咽癌、食管癌患者完成放化疗周期。
[Abstract]:Objective to evaluate the efficacy and safety of Introducer in patients with dysphagia. Methods A retrospective analysis of 22 patients with dysphagia and 6 patients with gastrostomy performed gastrostomy by general gastroscope was made in 16 patients with difficulty in opening their mouth. If the larynx or esophagus stricture could not pass through the common gastroscope, the PEG could be completed by nasal or oral superfine gastroscopy to observe the clinical curative effect and complications. Results 22 cases of PEG were successfully performed, of which 2 cases of nasopharyngeal carcinoma underwent gastrostomy via nasal or oral gastrostomy after radiotherapy, 14 cases with severe larynx and esophageal stricture and the patients who could not pass through general gastroscope. The average operating time of PEG group and PEG group were 12.2 卤2.9) and 11.8 卤3.2 min, respectively, but the latter had higher success rate and better comfort. One patient had fistula infection, no bleeding, esophageal and gastroenteric perforation, entrapment syndrome and other complications. Prophylactic PEG was performed in 17 patients with nasopharyngeal carcinoma and esophageal carcinoma, and the complete rate was 100.0.The nutritional parameters (hemoglobin, albumin, red blood cell count) before and after radiotherapy were matched t test. The difference was statistically significant (P 0.05). Conclusion Introducer gastrostomy is a more safe and effective method for enteral nutrition, especially for patients with difficult opening of mouth, pharynx and larynx or severe stricture of esophagus. Prophylaxis of PEG can help patients with advanced nasopharyngeal carcinoma and esophageal cancer to complete the radiotherapy and chemotherapy cycle.
【作者单位】：湖北民族学院附属民大医院消化内科;湖北民族学院附属民大医院肿瘤科;
【基金】：湖北民族学院博士启动基金(No:MY2014B021)
【分类号】：R459.3

【相似文献】