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目的探讨经皮内镜下胃造瘘(PEG)术在老年吞咽障碍患者肠内营养支持中的应用效果。方法回顾性分析20l3年1月至2016年1月在江门市新会人民医院消化科住院的老年吞咽障碍患者60例,随机分为观察组和对照组,各30例。对照组患者给予传统的外科手术胃造瘘术,观察组患者给予经皮内镜下胃造瘘(PEG)术,观察两组患者手术时间、出血量、管饲总时间;全部患者于术前、术后1个月,观察三头肌皮褶厚度(TSF)、前白蛋白(PA)、体质量指数(BMI)、白蛋白(ALB)等营养指标。记录两组患者穿刺部出血、切口发红感染、反流误吸、吸入性肺炎渗漏等并发症发生情况,并进行统计学分析。结果观察组患者手术时间、出血量、管饲总时间等指标均明显低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组患者TSF、PA、BMI、ALB等主要营养指标与本组治疗前及对照组治疗后比较,差异均有统计学意义(P<0.05)。观察组和对照组患者术后并发症发生率分别为3.33%、23.33%,差异有统计学意义(χ~2=4.12,P<0.05)。结论 PEG能改善老年患者的营养状况,减少经胃管鼻饲相关并发症。
Objective To investigate the effect of percutaneous endoscopic gastrostomy (PEG) on enteral nutrition in elderly patients with swallowing disorders. Methods A retrospective analysis of 60 elder swallowing patients hospitalized in Department of Gastroenterology, Xinhui Peoples Hospital, Jiangmen from January 2013 to January 2016 were randomly divided into observation group and control group, with 30 cases in each group. Patients in the control group were given conventional surgical gastrostomy. Patients in the observation group were treated with percutaneous endoscopic gastrostomy (PEG). The operation time, blood loss and total tube feeding time were observed in both groups. All patients underwent preoperative One month after operation, TSF, PA, BMI, ALB and other nutritional indicators were observed. Record the two groups of patients with puncture bleeding, incisional redness infection, reflux aspiration, aspiration pneumonia leakage and other complications, and statistical analysis. Results The operation time, blood loss and total tube feeding time in the observation group were significantly lower than those in the control group (P <0.05). After treatment, the main nutritional indexes such as TSF, PA, BMI and ALB in the observation group were significantly different from those in the control group before and after treatment (P <0.05). The incidence of postoperative complications in observation group and control group were 3.33% and 23.33%, respectively, with significant difference (χ ~ 2 = 4.12, P <0.05). Conclusion PEG can improve the nutritional status of elderly patients and reduce the complications associated with nasogastric feeding.