【摘要】 目的 比较CT引导下和内镜下经皮胃造瘘术在肌萎缩侧索硬化（ALS）患者中的临床应用效果。方法104例ALS患者中48例行CT引导下经皮胃造瘘术（CT引导组），56例行内镜下经皮胃造瘘术（内镜组）。比较2组患者的疾病情况、住院时间、术后住院时间、术后并发症情况以及术后半年及1年生存率。结果 2组患者年龄、病程、吞咽困难时间、身高、体质量、术前营养状况差异无统计学意义（P>0.05）。CT引导组患者住院时间和术后住院时间较内镜组缩短（P<0.05）。内镜组并发症发生率（19.6%）和CT引导组（8.3%）比较差异无统计学意义（P>0.05）。内镜组与CT引导组术后1年生存率差异均无统计学意义（91.0%vs. 93.8%,Log-rank χ~2=1.606,P>0.05）。结论 CT引导下经皮胃造瘘术在缩短ALS患者住院时间及术后住院时间方面具有明显优势，值得临床广泛推广。更多还原

【Abstract】 Objective To compare the clinical effects of CT-guided and endoscopic surgical percutaneous gastrostomy in patients with amyotrophic lateral sclerosis(ALS).Methods The clinical data of 104 patients with ALS were retrospectively analyzed,including 48 patients underwent CT-guided percutaneous gastrostomy(CT-guided group) and 56patients underwent endoscopic percutaneous gastrostomy(endoscopic group).The disease status,length of hospital stay,postoperative length of hospital stay,postoperative complications,and survival rates of six months and one year after surgery were compared between the two groups.Results There were no significant differences in age,disease course,dysphagia time,height,body weight and preoperative nutritional status between the two groups(P> 0.05).The length of hospital stay and postoperative length of stay were shorter in the CT-guided group than those in the endoscopic group(P<0.05).There was no significant difference in the incidence of complications between the endoscopic group(19.6%) and the CT-guided group(8.3%,P>0.05).There was no significant difference in one-year survival rate between the endoscopic group and the CT-guided group(91.0% vs 93.8%,Log-rank χ~2=1.606,P>0.05).Conclusion CT-guided percutaneous gastrostomy shows its advantages in ALS,especially in shortening the length of hospital stay and postoperative length of hospital stay in ALS patients,and is worthy of widespread clinical application.更多还原