摘要
目的探讨脑卒中后吞咽功能障碍患者经皮内镜下胃造瘘术（PEG）术前各种因素与术后死亡之间的关系，评估放置PEG管的必要性。方法52例入组患者，详细记录了PEG前各种参数及术后生存情况，并分析病例的死亡时间特点。对术前和术后的肺炎以及消化道出血情况进行比较分析。结果52例患者随访期内总共死亡16例，其中15例（93．4％）在术后3个月内死亡。年龄和美国麻醉师协会（ASA）评分显示与死亡有独立相关性，P值分别为0．026及0．001。PEG管置放前后吸入性肺炎发生率（50．0％比34．6％）及上消化道出血的发生率（5．8％比7．7％）比较，差异无统计学意义。结论放置了PEG管后多数死亡病例是在短期内（3个月）出现。年龄、ASA评分与卒中患者放置PEG管后的死亡风险相关。PEG并不能降低卒中患者吸入性肺炎及消化道出血的发生率。
Objective To investigate the factors influencing the death of patients who accepted percutaneous endoscopic gastrostomy （PEG） for stroke-caused dysphagia and to assess the necessity of PEG. Methods A total of 52 patients were recruited to the study. All features before PEG and survival situation after PEG were recorded, furthermore, Characteristic of death terminal point was analysed. Aspiration pneumonia and upper gastrointestinal hemorrhage before and after PEG were compared. Results Death toll was 16 in total 52 patients, among whoml5 patients （93.4%） died in 3 months after PEG. Age and ASA （ American Society of Anesthesia） score had independent correlation with death after PEG （ P = 0. 026 and P = 0. 001, respectively）. No statistic difference was found in morbidity of aspiration pneumonia and upper gastrointestinal hemorrhage before and after PEG （P = 0. 16 and P = 1.00, respectively）. Conclusion The majority death occurs in 3 months after PEG. There is correlation between advanced age and higher ASA score and death risk after PEG. PEG can＇t reduce the risk of aspiration pneumonia and upper gastrointestinal hemorrhage of patients with stroke.
出处
《中华消化内镜杂志》
2012年第11期618-620,共3页
Chinese Journal of Digestive Endoscopy
基金
基金项目：卫生部北京医院中青年医师人才培养专项基金资助项目
关键词
胃造口术
内窥镜检查
吞咽障碍
脑血管意外
Gastrostomy
Endoscopy
Deglutition disorders
Cerebrovascular accident
