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【文摘发布】内镜下胃造瘘术的并发症和预测因
Author:Figueiredo FA, da Costa MC, Pelosi AD, Martins RN, Machado L, Francioni E.
Resource: Endoscopy. 2007 Apr;39(4):333-8
Abstract: BACKGROUND AND STUDY AIMS: Percutaneous endoscopic gastrostomy (PEG) is the preferred route for long-term enteral feeding. Our aims were to prospectively evaluate the outcome ("PEG status") and complications of PEG and to determine whether these can be predicted by patients' baseline characteristics. PATIENTS AND METHODS: We conducted a prospective study in two tertiary hospitals between August 2003 and January 2005, enrolling all patients who were undergoing PEG placement. We completed a questionnaire with details of demographic data, diagnosis, indication for PEG, Charlson's co-morbidity index, Barthel's index, laboratory tests, complications, and date and cause of death. Patients were followed at scheduled appointments. Univariate and multivariate analyses were performed. RESULTS: 168 patients (48% male, 52% female; mean age +/- standard deviation 74 +/- 16 years) underwent PEG using the pull technique. The main indication was neurogenic dysphagia (156 patients, 92.9%). Although most indications were appropriate, in half the cases these were established too late. There were no procedure-related deaths. Major complications occurred in four patients (2.4%); minor complications occurred in 52 patients (31%). No single variable could predict complications. Fifteen patients (9%) had the PEG removed. No single variable was independently associated with PEG removal. The mortality was 6.5% at 30 days, 17.3% at 90 days and 33.9% at 1 year. The C-reactive protein was the only predictive factor of early mortality (< or = 30 days), and Charlson's co-morbidity index was the only predictive factor of late mortality (> 30 days). CONCLUSIONS: PEG placement is an easy and safe procedure, although it is often requested too late. No single variable could predict complications or PEG removal. C-reactive protein was found to be predictive of early mortality and Charlson's index was predictive of late mortality.
PMID:17427069 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领 Title: Predicting outcomes and complications of percutaneous endoscopic gastrostomy.
题目：经皮内镜下胃造瘘术的并发症和预测因素研究
Abstract: BACKGROUND AND STUDY AIMS: Percutaneous endoscopic gastrostomy (PEG) is the preferred route for long-term enteral feeding. Our aims were to prospectively evaluate the outcome ("PEG status") and complications of PEG and to determine whether these can be predicted by patients' baseline characteristics.
摘要：
背景和研究目的：经皮内镜下胃造瘘术(PEG)是长期胃肠营养的首选措施。本研究的目的是前瞻性评估PEG的效果和并发症并决定这些能否被患者的基础状态所预测。
PATIENTS AND METHODS: We conducted a prospective study in two tertiary hospitals between August 2003 and January 2005, enrolling all patients who were undergoing PEG placement. We completed a questionnaire with details of demographic data, diagnosis, indication for PEG, Charlson's co-morbidity index, Barthel's index, laboratory tests, complications, and date and cause of death. Patients were followed at scheduled appointments. Univariate and multivariate analyses were performed.
患者和方法： 2003年8月和2005年1月期间在两所三甲医院进行了一项前瞻性研究，记录了所有进行PEG的患者。这项调查表包括PEG患者的详细人数统计数据、诊断和适应征，Charlson's同病指数、Barthel's指数、实验室试验、并发症、死亡日期和原因。病人按照列表安排随访。应用单变量和多变量分析。
RESULTS: 168 patients (48% male, 52% female; mean age +/- standard deviation 74 +/- 16 years) underwent PEG using the pull technique. The main indication was neurogenic dysphagia (156 patients, 92.9%). Although most indications were appropriate, in half the cases these were established too late. There were no procedure-related deaths. Major complications occurred in four patients (2.4%); minor complications occurred in 52 patients (31%). No single variable could predict complications. Fifteen patients (9%) had the PEG removed. No single variable was independently associated with PEG removal. The mortality was 6.5% at 30 days, at 90 days and at 1 year. The C-reactive protein was the only predictive factor of early mortality (< or = 30 days), and Charlson's co-morbidity index was the only predictive factor of late mortality (> 30 days).
结果：168例患者使用拖入技术进行PEG (48% 男性, 52% 女性; 平均年龄 +/- 标准差 74 +/- 16 年).主要适应征是神经性吞咽困难（156名患者，92.9%).虽然大多数适应征是合适的，但有一半病例确诊太晚。没有手术相关死亡。4例患者(占2.4%)发生主要并发症，52例患者（占31%）发生次要并发症。单变量不能预测并发症。15例患者(9%)移除PEG管。没有独立的单变量与移除PEG管相关。30天死亡率是6.5%，90天是17.3% ，1年死亡率是33.9%。C-反应蛋白是唯一早期死亡率的预测因素(≤ 30 days)，Charlson's同病指数是唯一晚期死亡率的预测因素(> 30 days)。
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作者:admin@医学,生命科学 2011-06-02 05:11
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