| Objectives:Explore the safety and feasibility of percutaneous endoscopic gastrostomy, and the superiority compared with traditional nasogastric tube nutrition. Evaluate the effect of percutaneous endoscopic gastrostomy clinical application.Methods:In this retrospective study,73patients were selected from Nannng the first hospital, the first affiliated hospital of Guangxi university of troditional Chinese medicine,and the first affiliated hospital of Guangxi medical university during March2002to June2012, analysis of patient’s nutritional status and its complications with a nasogastric tube and PEG. All patients accepted a nasogastric tube feeding and PEG feeding more than one month, Record the following indicators:①the operating time and success rate,②Intraoperative complications, including blood pressure fluctuations, oxygen saturation (SpO2) of less than0.90, the puncture site bleeding puncture failure.③Postoperative complications, including puncture site bleeding, stoma infection, accidental extubation, intestinal perforation, peritonitis, gastrocolic fistula, necrotizing fasciitis, regurgitation and aspiration, aspiration pneumonia and leakage.④the patient’s nutritional indicators of the PEG catheter before and after a month. Including the white blood cells, lymphocyte count, plasma hemoglobin, total protein, albumin and transferrin change and weight, body mass index change.⑤the patients with aspiration pneumonia and reflux esophagitis before and after PEG.Results:73patients were successfully completed PEG operation. The success rate is100%. Operating time15-30min.Blood pressure was stable during the operation, four cases of SpO2falls below once to0.8, increase after the flow of oxygen, SpO2rose to0.95after the suspension of operations5min continue to complete the surgery. bleeding less in5ml, Fistula in good position Patients with local swelling and exudate of the skin around the stoma seven cases, three cases of low-grade fever, and vomiting after feeding five cases,6cases of diarrhea, and four cases constipation, four cases of local pain, pneumoperitoneum three cases of aspiration pneumonia in11cases. after PEG.3patients removed the PEG tube accidentally after PEG20days to one month and fistula is a small amount of bleeding, The symptoms was controled after treatment and the PEG tube was given to replacement.No serious complications was found, such as colon injury and gastrocolocutaneous fistula, peritonitis and Buried bumper syndrome. No fistula clogging, the patients have a better tolerance to PEG tube. Improved nutritional status of patients, weight loss under control, one month after enteral nutrition, white blood cells, lymphocyte count, plasma hemoglobin, total protein, albumin and transf errin changes and weight, body mass index were significantly improved.The incidence of pulmonary infection decreased from63.0%preoperatively to15.1%postoperatively, and that of reflux esophagitis decreased from27.4%to6.8%.Conclusions:PEG is a safe and feasible minimally invasive endoscopic surgery, has a short operating time, good effect of tube feeding, fewer and lighter complications. PEG can generally replace asogastric tube as the first choice of enteral nutrition for the patients with eating disorders. Objectives:To evaluate nutrition and quality of life improvement of the patients after percutaneous endoscopic gastrostomy (PEG)Methods:73cases of patients undergoing PEG were followed up at1,3and6months after feeding tube placement to determine the changes in white blood cells, lymphocyte count, plasma hemoglobin, total protein, albumin and transferrin protein changes and body weight, body mass index (BMI). The occurrence of complications such as pneumonia and reflux esophagitis was also recorded. Changes in quality of life before and after PEG was measured with the Short Form36Health Survey questionnaireResults:73patients were successfully finished PEG, nutritional status was significantly improved after PEG, weight loss under control, and after enteral nutrition for1month,3months and6months, the levelsof hemoglobin, total protein, albumin and transferrin, as well as body mass index significantly improved. There was significant difference before and after PEG (P<0.05). Pulmonary infection rate of63.0%of preoperative PEG (46/73), reducing to16.7%(11/66) after PEG; reflux esophagitis before surgery by the PEG27.4%(20/73) down to7.6%(5/66). At1,3and6months after feeding tube placement, there was a significant improvement of patients with physical health and mental health, as well as physiological function, social function compared with PEG preoperative.Conclusions:PEG significantly improved the nutritional status of postoperative patients, increased the levels of hemoglobin, total protein, albumin and transferrin, as well as body mass index significantly improved. PEG can also reduce the nasogastric tube caused by retention of reflux esophagitis and pulmonary infection, patients with good tolerance and is an ideal means of enteral nutrition. It can also improved the quality of life. |
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