Randomised comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with persisting neurological dysphagia.
Randomised comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with persisting neurological dysphagia.
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经皮内窥镜胃造口术和鼻胃管喂养对持续性神经性吞咽困难患者的随机比较。
DOI：
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发表时间：
1992
影响因子：
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通讯作者：
Peter R. Mills
中科院分区：
文献类型：
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作者：
R. Park;M. Allison;J. Lang;E. Spence;A. Morris;B. Danesh;R. Russell;Peter R. Mills
目的：比较经皮内镜下胃造口术和鼻胃管喂养在持续性神经性吞咽困难患者中的应用。设计：对需要长期肠内营养的住院患者进行为期28天的随机研究。环境--三家格拉斯哥教学医院。受试者--40例继发于神经系统疾病的吞咽困难至少4周的患者：20例患者（10名女性）随机接受鼻饲喂养，20例患者（8名女性）接受内镜下胃造口术。主要观察指标--治疗失败（三次或三次以上的插管堵塞或移位或拒绝继续治疗）;喂养持续时间;流质饮食摄入;并发症;试验结束时的营养状况。结果：每组各有一名患者在开始进食前死亡。治疗失败发生在18 19鼻胃患者和胃造口术组没有。鼻饲组的平均（SE）喂养持续时间为5.2（1.5）天。鼻饲组未发生并发症，但胃造口术组中有3例（16%）发生了轻微问题（吸入性肺炎（2例患者）和伤口感染（1例））。与鼻饲组（55%（4%）; p <0.001）相比，胃造口术患者接受的处方饲料比例（93%（2%））显著更高，并且在喂养7天后体重增加显著更多（1.4（0.5）kg vs 0.6（0.1）kg; p <0.05）。由于鼻饲组中剩余的数量较少，因此无法在第14、21和28天进行分析。结论-经皮内镜胃造口管饲是一种安全有效的方法，为神经性吞咽困难患者提供长期肠内营养，并提供了重要的优势，鼻胃管饲。
OBJECTIVE--To compare percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with persisting neurological dysphagia. DESIGN--Randomised 28 day study of inpatients requiring long term enteral nutrition. SETTING--Three Glasgow teaching hospitals. SUBJECTS--40 patients with dysphagia for at least four weeks secondary to neurological disorders: 20 patients (10 women) were randomised to nasogastric feeding and 20 (eight women) to endoscopic gastrostomy. MAIN OUTCOME MEASURES--Treatment failure (blocked or displaced tubes on three or more occasions or refusal to continue treatment); duration of feeding; intake of liquid diets; complications; nutritional status at end of trial. RESULTS--One patient in each group died before starting feeding. Treatment failure occurred in 18 of the 19 nasogastric patients and in none of the gastrostomy group. The mean (SE) duration of feeding for the nasogastric group was 5.2 (1.5) days. No complications occurred in the nasogastric group but three (16%) of the gastrostomy group developed minor problems (aspiration pneumonia (two patients) wound infection (one)). Gastrostomy patients received a significantly greater proportion of their prescribed feed (93% (2%)) compared with the nasogastric group, (55% (4%); p less than 0.001) and also gained significantly more weight after seven days of feeding (1.4 (0.5) kg v 0.6 (0.1) kg; p less than 0.05). Analyses at days 14, 21, and 28 were not possible due to the small numbers remaining in the nasogastric group. CONCLUSION--Percutaneous endoscopic gastrostomy tube feeding is a safe and effective method of providing long term enteral nutrition to patients with neurological dysphagia and offers important advantages over nasogastric tube feeding.