背景:经皮内镜胃造瘘术(PEG)对于吞咽受损和胃肠道系统功能正常的患者是一种有用的干预措施。引起神经运动性吞咽困难的神经系统疾病,脑肿瘤,脑血管疾病是最常见的适应症;并发症很少见,发病率和死亡率都很低。
目的:描述PEG在神经系统疾病患者中的应用,以及它对护理的影响,生存,成本和收益。
方法:我们进行了一项回顾性观察研究,回顾了在美国国家神经病学和神经外科研究所住院的患者(2015-2017年)接受PEG安置的临床档案.
结果:样本包括51例患者:62.7%为女性,平均(SD)年龄为54.4(18.6)岁(范围,18-86).肿瘤占37.3%,脑血管病占33.3%。16例患者(33.3%)死亡,11例出现轻微并发症。PEG管保持在原位平均9.14个月;在52.9%的患者中,由于缺乏改善和/或耐受口服摄入,移除发生在平均5.1(4.4)个月后。在患者家属中,78.4%的人报告说有很大的好处,43.1%的人报告难以照顾PEG,45.1%报告一般护理复杂。维持PEG的每月成本平均为175.78欧元(范围,38.38-293.45)。
结论:这项初步研究表明,PEG在神经系统疾病患者中的适应症很好,生存率与其他长期随访研究中报道的相似。在脑血管病患者中,PEG管平均保持在9.14个月,在吞咽功能恢复期间;然而,对我们的人口来说成本很高。
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is a useful intervention for patients with impaired swallowing and a functional gastrointestinal system. Neurological diseases that cause neuromotor dysphagia, brain tumors, and cerebrovascular disease are the most frequent indications; complications are rare, and morbidity and mortality rates are low.
OBJECTIVE: To describe the usefulness of PEG in patients with neurological diseases, and its impact on care, survival, and costs and benefits.
METHODS: We performed a retrospective observational
study, reviewing clinical files of patients hospitalised at the National Institute of Neurology and Neurosurgery (years 2015-2017) who underwent PEG placement.
RESULTS: The sample included 51 patients: 62.7% were women and the mean (SD) age was 54.4 (18.6) years (range, 18-86). Diagnosis was tumor in 37.3% of cases and cerebrovascular disease in 33.3%. Sixteen patients (33.3%) died and 11 presented minor complications. The PEG tube remained in place for a mean of 9.14 months; in 52.9% of patients it was removed due to lack of improvement and/or tolerated oral intake, with removal occurring after a mean of 5.1 (4.4) months. Among patients\' family members, 78.4% reported a great benefit, 43.1% reported difficulty caring for the PEG, and 45.1% reported complicated care in general. The monthly cost of maintaining the PEG was €175.78 on average (range, 38.38-293.45).
CONCLUSIONS: This preliminary
study reveals that PEG was well indicated in patients with neurological diseases, with survival rates similar to those reported in other studies with long follow-up periods. In patients with cerebrovascular disease, the PEG tube remained in place a mean of 9.14 months, during recovery of swallowing function; however, the cost is high for our population.