经皮内镜下胃造口术和鼻胃管给予肠内营养的效果比较

目的观察胃造口管(经皮内镜下胃造口术留置)及鼻胃管给予肠内营养的疗效区别。方法因吞咽功能障碍或意识障碍需要较长时间(4周)实行管饲营养的门诊或住院患者50例,根据患者及其家属是否接受分为经皮内镜下胃造口术(PEG)组和鼻胃管(NGT)组。PEG组实行经皮内镜下胃造口术,术后通过胃造口管给予肠内营养;NGT组实行鼻胃管给予肠内营养,观察两组患者管饲过程的并发症包括返流、吸入性肺炎等的发生情况,以及人体测量指标和实验室检查指标包括三头肌皮褶厚度(TSF)、上臂围(AC)、上臂肌围(AMC)、血清白蛋白(ALB)、前白蛋白(PA)的变化,观察期为3个月。结果治疗3个月后,NGT组的ALB、PA、TSF值均较治疗前升高,差异有统计学意义(P0.05),而PEG组的ALB、PA、TSF、MC值均较治疗前升高,差异有统计学意义(P0.05),且PEG组ALB、PA升高的量高于NGT组,PEG组治疗效果优于NGT组,差异有统计学意义(P0.05);PEG组3个月内返流和吸入性肺炎等常见并发症发生率低于NGT组,差异均有统计学意义(P0.05)。结论对于需要较长时间管饲喂养的病人,PEG的疗效明显优于传统的NGT。

Comparison of the outcomes of nutritional support by nasogastric tube and percutaneous endoscopic gastrostomy tubes for long-term enteral nutrition people

Objective To compare the outcomes of long-term enteral nutrition by nasogastric tube （NGT） with that of percutaneous endoscopic gastrostomy （PEG） tube. Methods Patients who received long-term enteral nutrition were divided into two groups. One group received enteral nutrition by PEG, the other group by NGT. We examined the indications for enteral nutrition, nutritional status, outcome and complications in all subjects. Subjects were followed for a minimum period of three months. Results A significant improvement in the serum albumin and prealbumin level at 3- month follow-up assessment in the patients with PEG and NGT（P〈O.05）. Compared to the NGT group, the improvement in PEG group was more significant （P〈0.05）. The patients of PEG group had a lower rate of palirrhea and aspiration pneumonia than those of NGT group（P〈0.05）. Conclusion In long-term enteral nutrition,PEG is superior to NGT.