经皮胃造瘘术治疗肌萎缩侧索硬化症吞咽困难51例

发布时间：2018-02-26 01:08

本文关键词： 肌萎缩侧索硬化症经皮透视下胃造瘘术　出处：《介入放射学杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的评价X线下经皮胃造瘘术(PRG)在51例肌萎缩侧索硬化症(ALS)吞咽困难患者中的临床应用,评估PRG对肺功能不全ALS患者的安全性及营养状况的改善作用。方法回顾性分析51例行PRG手术的ALS患者。记录手术成功率,观察术后并发症情况。术后对患者进行定期随访,记录患者长期并发症及术后1、3、6个月病死率,评估术后营养状况的改变。结果为51例ALS患者行PRG手术,手术成功率100%。7例患者(13.7%)出现轻微并发症,出现1例(2.0%)大出血严重并发症,术后未发现患者呼吸功能受损情况。术后1、3个月无患者死亡,术后6个月死亡3例(6.8%,3/44)。术后1个月31例患者体重增加超过1 kg,平均BMI从术前18.60±2.14增加到19.27±1.81(术后1个月)、19.17±1.93(术后3个月)和18.89±2.33(术后6个月)。结论 PRG无需胃镜和麻醉,降低了肺功能差的ALS患者的经皮胃造瘘术的误吸窒息风险,提高了手术成功率和安全性,是保证肺功能不全ALS患者足够的能量摄入、改善患者营养状况的有效手段之一。
[Abstract]:Objective to evaluate the clinical application of percutaneous gastrostomy (PRG) under X-ray in 51 patients with dysphagia in patients with amyotrophic lateral sclerosis (ALS). To evaluate the effect of PRG on the safety and nutritional status of patients with pulmonary insufficiency ALS. Methods 51 ALS patients undergoing PRG operation were retrospectively analyzed. The success rate of the operation was recorded and the postoperative complications were observed. The patients were followed up regularly after operation. The long-term complications and mortality of 1, 6 months after operation were recorded, and the nutritional status was evaluated. The results showed that 51 patients with ALS underwent PRG operation, and the successful rate of operation was 100. 7 cases with mild complications and 1 case with severe complications of massive hemorrhage. No postoperative respiratory impairment was found. There was no death at 1 or 3 months after operation. 3 patients died 6 months after operation, 31 patients gained weight more than 1 kg, the average BMI increased from 18.60 卤2.14 to 19.27 卤1.81 (1 month after operation) and 18.89 卤2.33 (6 months after operation). Conclusion PRG does not need gastroscopy and anesthesia. It can reduce the risk of aspiration asphyxia in ALS patients with poor pulmonary function and improve the success rate and safety of the operation. It is one of the effective methods to ensure sufficient energy intake and improve nutritional status of patients with pulmonary insufficiency ALS.
【作者单位】：徐汇区大华医院介入肿瘤科;交通大学附属第六人民医院介入影像科;
【分类号】：R744.8

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