肌萎縮側索硬化患者行經皮內鏡下胃造瘺術術后并發癥的觀察及護理_West China Medical Journal

Authors：

 梁燕 , 李銀萍 , 陳德智

四川大學華西醫院神經內科（成都 610041）;

Corresponding?author：

Keywords：

肌萎縮側索硬化; 經皮內鏡下胃造瘺術; 并發癥; 護理

DOI：

10.7507/1002-0179.20150497

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目的對肌萎縮側索硬化（ALS）患者經皮內鏡下胃造瘺術（PEG）術后并發癥的觀察及護理進行總結和分析。方法回顧性分析2013年4月－2014年4月被確診為ALS且行PEG手術的8例患者的臨床資料，觀察并發癥發生情況并總結護理經驗。結果 8例患者中1例并發腹膜炎及造瘺口疼痛自動出院；其余7例中并發造瘺口緣端感染及造瘺口疼痛1例，術后瘺口出血及造瘺口疼痛1例，造瘺口滲漏及造瘺口疼痛1例，術后造瘺口疼痛1例，3例無術后并發癥。7例患者經治療及護理后均好轉并帶管出院，最長保留胃造瘺管者在造瘺后第370天因留置時間到期更換胃造瘺管。結論 PEG是ALS患者出現吞咽障礙后最主要的營養支持手段，術前的充分評估及術后的密切觀察、護理是減少并發癥的主要手段。

Citation： 梁燕, 李銀萍, 陳德智. 肌萎縮側索硬化患者行經皮內鏡下胃造瘺術術后并發癥的觀察及護理. West China Medical Journal, 2015, 30(9): 1736-1738. doi: 10.7507/1002-0179.20150497 Copy

1.	李曉光, 郭玉璞, 李士釗, 等. 運動神經元病流行病學[M]//李士釗. 神經疾病流行病學. 北京:人民衛生出版社, 2001:284-289.
2.	Desport JC, Preux PM, Magy L, et al. Factors correlated with hypermetabolism in patients with amyotrophic lateral sclerosis[J]. Am J Clin Nutr, 2001, 74(3):328-334.
3.	Miller RG, Jackson CE, Kasarskis EJ, et al. Practice Parameter update:the care of the patient with amyotrophic lateral sclerosis:drug, nutritional, and respiratory therapies (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology[J]. Neurology, 2009, 73(15):1218-1226.
4.	Brooks BR, Miller RG, Swash M, et al. El Escorial revisited:revised criteria for the diagnosis of amyotrophic lateral sclerosis[J]. Amyotrophic Lateral Sclerosis, 2000, 1(5):293-299.
5.	江志偉, 汪志明, 黎介壽, 等. 經皮內鏡下胃造口、空腸造口及十二指腸造口120例臨床分析[J]. 中華外科雜志, 2005, 43(1):19-21.
6.	吳惠芳, 李佩尼, 黎淑珍. 15例經皮內鏡下胃造瘺術的護理[J]. 全科護理, 2010, 8(35):3221-3222.
7.	Bechtold ML, Matteson ML, Choudhary A, et al. Early versus delayed feeding after placement of a percutaneous endoscopic gastrostomy:a meta-analysis[J]. Am J Gastroenterol, 2008, 103(11):2919-2924.
8.	姜躍龍, Xinsheng Liu, Daniel KY Chan. 內鏡下經皮胃造瘺術的并發癥及防治進展[J]. 臨床消化病雜志, 2013, 25(1):58-61.
9.	劉啟勝, 董衛國. 經皮內鏡胃造瘺患者的循證治療[J]. 世界華人消化雜志, 2011, 19(20):2185-2189.
10.	Wiggins TF, Kaplan R, DeLegge MH. Acute hemorrhage following transhepatic PEG tube placement[J]. Digest Dis Sci, 2007, 52(1):167-169.
11.	Wiesen AJ, Sideridis K, Fernandes A, et al. True incidence and clinical significance of pneumoperitoneum after PEG placement:a prospective study[J]. Gastrointest Endosc, 2006, 64(6):886-889.

1. 李曉光, 郭玉璞, 李士釗, 等. 運動神經元病流行病學[M]//李士釗. 神經疾病流行病學. 北京:人民衛生出版社, 2001:284-289.
2. Desport JC, Preux PM, Magy L, et al. Factors correlated with hypermetabolism in patients with amyotrophic lateral sclerosis[J]. Am J Clin Nutr, 2001, 74(3):328-334.
3. Miller RG, Jackson CE, Kasarskis EJ, et al. Practice Parameter update:the care of the patient with amyotrophic lateral sclerosis:drug, nutritional, and respiratory therapies (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology[J]. Neurology, 2009, 73(15):1218-1226.
4. Brooks BR, Miller RG, Swash M, et al. El Escorial revisited:revised criteria for the diagnosis of amyotrophic lateral sclerosis[J]. Amyotrophic Lateral Sclerosis, 2000, 1(5):293-299.
5. 江志偉, 汪志明, 黎介壽, 等. 經皮內鏡下胃造口、空腸造口及十二指腸造口120例臨床分析[J]. 中華外科雜志, 2005, 43(1):19-21.
6. 吳惠芳, 李佩尼, 黎淑珍. 15例經皮內鏡下胃造瘺術的護理[J]. 全科護理, 2010, 8(35):3221-3222.
7. Bechtold ML, Matteson ML, Choudhary A, et al. Early versus delayed feeding after placement of a percutaneous endoscopic gastrostomy:a meta-analysis[J]. Am J Gastroenterol, 2008, 103(11):2919-2924.
8. 姜躍龍, Xinsheng Liu, Daniel KY Chan. 內鏡下經皮胃造瘺術的并發癥及防治進展[J]. 臨床消化病雜志, 2013, 25(1):58-61.
9. 劉啟勝, 董衛國. 經皮內鏡胃造瘺患者的循證治療[J]. 世界華人消化雜志, 2011, 19(20):2185-2189.
10. Wiggins TF, Kaplan R, DeLegge MH. Acute hemorrhage following transhepatic PEG tube placement[J]. Digest Dis Sci, 2007, 52(1):167-169.
11. Wiesen AJ, Sideridis K, Fernandes A, et al. True incidence and clinical significance of pneumoperitoneum after PEG placement:a prospective study[J]. Gastrointest Endosc, 2006, 64(6):886-889.

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West China Medical Journal

肌萎縮側索硬化患者行經皮內鏡下胃造瘺術術后并發癥的觀察及護理

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