【摘要】 目的探讨透视引导下经皮穿刺胃造瘘术(PG)和胃空肠造瘘术(PGJ)的可行性和安全性。方法23例吞咽困难的患者。上段食管癌10例,中段食管癌1例,咽部癌6例,球麻痹2例,脑转移瘤4例。采用美国Cook公司生产的Marx-copePGJ套装。先经鼻饲管经鼻或经口途径置入导管后注入气体800~1000ml,至胃腔明显扩张。然后在透视引导下采用Seldinger技术将PG饲管置入胃腔内,或将PGJ饲管经胃腔、十二指肠置入空肠内。术后严密观察腹部症状和体征。随访饲管使用情况。结果23例患者均成功完成PG术,技术成功率为100%。其中将饲管置入空肠内13例,均成功。术后出现上腹部疼痛1例,造瘘口周围感染1例,经处理后均痊愈。1例于术后第2天,因胃内容物反流出现窒息死亡。随访期间经饲管给予顺利。恶性肿瘤患者18例死亡,另3例仍在随访中,中位生存期为6.5个月。球麻痹患者1例更换新的PG饲管,另1例失访。结论透视引导下PG和PGJ术,成功率高,并发症少,是建立长期胃肠内营养的良好途径。更多还原

【Abstract】 Objective To evaluate the feasibility and safety of fluosocopically guided percutaneous gastrostomy (PG) and gastrojejunostomy (PGJ). Methods Twenty-three patients with swallowing disorders (15 men,8 women; age range 54-78 years; mean 64 years) were performed percutaneous PG and PGJ. The PG tubes (Marx-cope PGJ set ; Cook ) were successfully placed in 23 patients and the PGJ tubes were accomplished in 13 patients. Results The 23 patients had technically successful placement of PG tubes ( n =23) and PGJ tubes ( n =13). The technical success rates were both 100%. The times for performing procedures and fluroscopy were 30-90 min (mean 60 min) and 5-10 min (mean 5.5 min), respectively. Regurgitation of gastric content occurred in 1 patient with PG tubes 2 days after procedure and the patient died due to apnea. Upper abdominal pain occurred in 1 patient and peri-tube infection in another after operation, both were successfully treated with oral antibiotics. The tubes sustained safely during follow up period (1 -16 months,mean 6). Conclusions Percutaneous approach of fluoroscopically guided PG and PGJ are safe and feasible.更多还原