摘要
目的探讨经皮内窥镜引导下胃/空肠造口术(PEG/J)在危重患者中的临床应用。方法回顾性分析了30例行PEG/J危重患者的临床资料,并对手术指征、操作要点、围手术期处理、手术相关并发症和临床疗效进行总结。结果29例危重患者PEG/J获得成功,PEG平均操作时间为(7.5±2.5)min,PEJ为(12.5±8.2)min,PEG/J平均留置时间为(230±159)d,未发生术中置管相关并发症及术后严重并发症。术后1例患者出现局部软组织感染,1例出现J管脱入体内,2例出现空肠营养管堵塞。与术前相比,术后第4周患者的血清白蛋白和前白蛋白水平均有升高趋势,但差异无显著性。结论在危重患者中行PEG/J是建立长期胃肠道营养通路的有效方法,具有微创、安全、并发症少和易于护理等特点,患者耐受良好,可长期留置营养管。
Objective To explore the clinical value of percutaneous endoscopic gastrostomy/jejunostomy （PEG/J） in critically ill patients. Methods We retrospectively analysed the clinical data of 30 critically ill patients who received PEG/J in our hospital. The indications, key operation procedures, peri-operatire preparation, complications, and efficacy were recorded. Results Twenty-nine critically ill patients successfully received PEG/J. The mean operation time of PEG and PEJ were （7.5±2.5） min and （ 12.5±8.2） min, respectively, and the duration of tube functioning was （230 ±159） d; no procedure-related complications and serious complications were observed. Complications included local soft tissue infection （ n = 1 ） , J-tube dislodgment （ n = 1 ） , and obstruction of jejunal tube （ n = 2）. The serum levels of albumin and pre-albumin increased 4 weeks after operation; however, no significant difference was observed. Conclusion PEG/J is an effective, micro-invasive, safe, and convenient approach to establish a long-term gastrointestinal nutrition route for critically ill patients.
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2008年第3期253-256,共4页
Acta Academiae Medicinae Sinicae
