[1]达彬琳,张娟娟,刁艳青,等.经皮内镜下胃造口术在肌萎缩侧索硬化病人中的应用[J].肠外与肠内营养杂志,2021,(04):204-206.[doi:10.16151/j.1007-810x.2021.04.003]
　DA Bin-lin,ZHANG Juan-juan,DIAO Yan-qing,et al.Application of percutaneous endoscopic gastrostomy in patients with amyotrophic lateral sclerosis[J].PARENTERAL & ENTERAL NUTRITION,2021,(04):204-206.[doi:10.16151/j.1007-810x.2021.04.003]
点击复制

经皮内镜下胃造口术在肌萎缩侧索硬化病人中的应用
分享到：

《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2021年04期
页码:
204-206
栏目:
论著
出版日期:
2021-07-10

文章信息/Info

Title:
Application of percutaneous endoscopic gastrostomy in patients with amyotrophic lateral sclerosis
作者:
达彬琳; 张娟娟; 刁艳青; 钱小丽; 朱楠; 刘思彤; 汪志明
东部战区总医院普通外科研究所，江苏南京210002
Author(s):
DA Bin-lin;  ZHANG Juan-juan;  DIAO Yan-qing;  QIAN Xiao-li;  ZHU Nan;  LIU Si-tong;  WANG Zhi-ming
General Hospital of Eastern Theater Command, Research Institute of General Surgery, Nanjin 210002, Jiangsu,China
关键词:
肌萎缩侧索硬化 ; 营养支持 ; 经皮内镜下胃造口术 ; 内镜检查
Keywords:
Amyotropic lateral sclerosis;  Nutrition support;  Percutaneous endoscopic gastrostomy;  Endoscopy
分类号:
R656.6，R744.8
DOI:
10.16151/j.1007-810x.2021.04.003
文献标志码:
A
摘要:
目的：探讨经皮内镜下胃造口术（PEG）对于肌萎缩侧索硬化（ALS）伴有吞咽困难病人的安全性和有 效性。 方法：回顾性分析46例行PEG的ALS伴有吞咽困难病人的临床资料，分析PEG置管时间、成功率、并发症 及处理方法。 结果：本研究纳入了46例病人，男30例，女16例。平均置管时间为（8.8 ± 1.6）min，成功率为100%， 未发生置管相关并发症，置管后并发症的发生率为17.39%（8/46），包括造口感染2例，造口管堵塞2例，肺炎2例，造 口管近腹壁处折断1例，造口渗漏1例。术后30 d死亡1例，死亡率为2.17%。 结论：PEG操作简便、安全、有效、 易于护理、并发症少等优点，适合ALS伴有吞咽困难的病人。
Abstract:
Objective: To investigate the safety and efficacy of percutaneous endoscopic gastrostomy (PEG) for amyotrophic lateral sclerosis (ALS) with dysphagia. Methods: The clinical data of 46 ALS patients undergoing PEG were retrospectively analyzed. The time of PEG catheterization, success rate, complications and treatment methods were analyzed. Results: The study included a total of 46 ALS patients, 30 males and 16 females. The average catheterization time was (8.8 ± 1.6) min. The success rate was 100% with no catheterization related complications, and the incidence of post-catheterization complications was 17.39% (8/46), including 2 cases of stoma infection, 2 cases of ostomy tube blockage, 2 cases of pneumonia, 1 case which the ostomy tube near the abdominal wall was broken and 1 case of stoma leakage. The 30-day mortality was 2.17%. Conclusion: PEG is easy to operate, safe, effective, easy to care, less complications, suitable for ALS patients with dysphagia.

参考文献/References:


[1] Burgos R, Breton I, Cereda E, et al. ESPEN guideline clinical nutrition in neurology. Clin Nutr Edinb Scotl, 2018, 37(1):354-396.
[2] 汪志明 . 肠内营养支持途径的建立和管理 . 肠外与肠内营养,2017, 24(3):68-71.
[3] Farrag K, Shastri YM, Beilenhoff U, et al. Percutaneous endoscopic gastrostomy (PEG): a practical approach for long term management. BMJ, 2019, 364: k5311.
[4] Roveron G, Antonini M, Barbierato M, et al. Clinical Practice Guidelines for the Nursing Management of Percutaneous Endoscopic Gastrostomy and Jejunostomy (PEG/PEJ) in Adult Patients: An Executive Summary. J Wound Ostomy Continence Nurs, 2018, 45(4):326-334.
[5] Brown RH, Al-Chalabi A. Amyotrophic Lateral Sclerosis. N Engl J Med, 2017, 377(2): 162-172.
[6] Thomas K, Schrager J, Neel R, et al. Percutaneous endoscopic gastrostomy tube placement in amyotrophic lateral sclerosis: a case series with a multidisciplinary, team-based approach. Ann Gastroenterol, 2020, 33(5):480-484.
[7] L?ser C, Aschl G, Hébuterne X, et al. ESPEN guidelines on artificial enteral nutrition--percutaneous endoscopic gastrostomy (PEG). Clin Nutr, 2005, 24(5):848-861.
[8] Miller RG, Jackson CE, Kasarskis EJ, et al. Practice Parameter update: the care of the patient with amyotrophic lateral sclerosis: drug, nutritional, and respiratory therapies (an evidence-based review) Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 2009, 73(15):1218-1226.
[9] 宿英英, 潘速跃, 高亮, 等. 神经系统疾病经皮内镜下胃造口喂养中国专家共识. 肠外与肠内营养, 2015, 22(3):129-132.
[10] TheProgas Study Group. Gastrostomy in patients with amyotrophic lateral sclerosis (ProGas): a prospective cohort study. Lancet Neurol, 2015, 14(7):702-709.
[11] Forbes RB, Colville S, Swingler RJ. Frequency, timing and outcome of gastrostomy tubes for amyotrophic lateral sclerosis/motor neurone disease – a record linkage study from the Scottish Motor Neurone Disease Register. J Neurol, 2004, 251(7):813-817.
[12] EFNS Task Force on Diagnosis and Management of Amyotrophic Lateral Sclerosis: Andersen PM, Abrahams S, Borasio GD, et al. EFNS guidelines on the clinical management of amyotrophic lateral sclerosis (MALS)--revised report of an EFNS task force. Eur J Neurol, 2012, 19(3):360-375.
[13] Mariosa D, Beard JD, Umbach DM, et al. Body Mass Index and Amyotrophic Lateral Sclerosis: A Study of US Military Veterans. Am J Epidemiol, 2017, 185(5):362-371.
[14] Hucl T, Spicak J. Complications of percutaneous endoscopic gastrostomy. Best Pract Res Clin Gastroenterol, 2016, 30(5):769-781.
[15] Campoli PM, Paula AA, Alves LG, et al. Efiect of the introducer technique compared with the pull technique on the peristomal infection rate in PEG：a meta-analysis. Gastrointest Endosc, 2012, 75(5):988-996.
[16] Lipp A, Lusardi G. Systemic antimicrobial prophylaxis for percutaneous endoscopic gastrostomy. Cochrane Database Syst Rev, 2013, 2013(11):CD005571.
[17] Dandeles LM, Lodolce AE. Efficacy of agents to prevent and treat enteral feeding tube clogs. Ann Pharmacother, 2011, 45(5): 676-680.
[18] Westaby D, Young A, O’Toole P, et a1. The provision of a percutaneously placed enteral tube feeding service. Gut, 2010, 59(12): 1592-1605.
[19] Cobell WJ, Hinds AM, Nayani R, et a1. Feeding after percutaneous endoscopic gastrostomy：experience of early versus delayed feeding. South Med J, 2014, 107(5): 308-311.

相似文献/References:

[1]王蕾蕾,陈秋霞,张片红,等.营养教育对病人营养风险筛查和营养支持效果的影响[J].肠外与肠内营养杂志,2014,(05):270.[doi:1007-810X（2014）05-0270-03]
　WANG Lei-lei,CHEN Qiu-xia,ZHANG Pian-hong,et al.Effect of nutrition education on nutritional risk screening and support in patients[J].PARENTERAL & ENTERAL NUTRITION,2014,(04):270.[doi:1007-810X（2014）05-0270-03]
[2]李洪涛,刘洪斌.残胃癌围手术期营养支持[J].肠外与肠内营养杂志,2018,(04):193.[doi:10.16151/j.1007-810x.2018.04.001]
[3]马 涛,刘 彤.围手术期营养支持[J].肠外与肠内营养杂志,2018,(05):262.[doi:10.16151/j.1007-810x.2018.05.002 ]
[4]林 照,徐 颖,葛卫星,等.苏皖地区部分重症医师对重症病人营养支持指南临床实施情况调查与分析[J].肠外与肠内营养杂志,2018,(06):342.[doi:10.16151/j.1007-810x.2018.11.005]
　LIN Zhao,X? Ying,GE Wei-xing,et al.Survey and Analysis of Clinical Practice of Nutritional Support Guidelines for Critically Ill Patients by Some Doctors of Intensive Care Units in Jiangsu and Anhui Area[J].PARENTERAL & ENTERAL NUTRITION,2018,(04):342.[doi:10.16151/j.1007-810x.2018.11.005]
[5]吴 孟,连晓娇,孙 萍.矿难病人营养支持对预防再喂养综合征的作用[J].肠外与肠内营养杂志,2019,(02):87.[doi:10.16151/j.1007-810x.2019.02.006]
　WU Meng,LIAN Xiao-jiao,SUN Ping.Effect of nutrition support on prevention of refeeding syndrome for the patients in the mining disaster[J].PARENTERAL & ENTERAL NUTRITION,2019,(04):87.[doi:10.16151/j.1007-810x.2019.02.006]
[6]顾璐璐,陶 晶,吴翠丽,等.1例高龄腹部术后急性肠损伤病人个体化营养与早期运动的管理[J].肠外与肠内营养杂志,2019,(04):253.[doi:DOI : 10.16151/j.1007-810x.2019.04.014]
[7]施晓宇,蒋琪霞,刘喜平.营养支持在老年压疮病人预后影响因素中重要性的临床分析[J].肠外与肠内营养杂志,2020,(01):37.[doi:DOI : 10.16151/j.1007-810x.2020.01.009]
　SHI Xiao-yu,JIANG Qi-xia,LIU Xi-ping.Nutritional support as an important prognostic factor of older patients with pressure ulcers[J].PARENTERAL & ENTERAL NUTRITION,2020,(04):37.[doi:DOI : 10.16151/j.1007-810x.2020.01.009]
[8]唐淑慧,王 汇,夏陈成,等.消化道恶性肿瘤化疗病人营养状况现况调查和影响因素分析[J].肠外与肠内营养杂志,2021,(01):35.[doi:DOI : 10.16151/j.1007-810x.2021.01.008]
　TANG Shu-hui,WANG Hui,XIA Chen-cheng,et al.Investigation on nutritional status of patients with gastrointestinal cancer undergoing chemotherapy[J].PARENTERAL & ENTERAL NUTRITION,2021,(04):35.[doi:DOI : 10.16151/j.1007-810x.2021.01.008]
[9]何建冰,段红兵,康健乐,等.食管癌病人围手术期营养状况对其术后恢复的影响[J].肠外与肠内营养杂志,2021,(02):75.[doi:10.16151/j.1007-810x.2021.02.003]
　HE Jian-bing,DUAN Hong-bing,KANG Jian-le,et al.The effect of perioperative nutritional status on postoperative recovery of patients with EC[J].PARENTERAL & ENTERAL NUTRITION,2021,(04):75.[doi:10.16151/j.1007-810x.2021.02.003]
[10]邵灵慧,祝倩雯,窦 昀,等.1例重度溃疡性结肠炎病人 TPC+IPAA术后发生全小肠炎的营养支持护理[J].肠外与肠内营养杂志,2021,(02):126.[doi:DOI : 10.16151/j.1007-810x.2021.02.013]

备注/Memo

备注/Memo:
作者简介 ：达彬琳，住院医师，医学硕士，主要从事普通外科内镜专业。E-mail：tmusy0212@163.com 通讯作者 ：汪志明，E-mail：wzmdoc@163.com
更新日期/Last Update: 1900-01-01