Gastrostomy placement in paediatric patients with neuromuscular disorders: indications and outcome
Gastrostomy placement in paediatric patients with neuromuscular disorders: indications and outcome
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DOI：
10.1111/j.1469-8749.2007.00367.x
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发表时间：
2007-05-01
影响因子：
3.8
通讯作者：
Muntoni, Francesco
中科院分区：
文献类型：
--
作者：
Ramelli, Gian Paolo;Aloysius, Annie;Muntoni, Francesco
对患有神经发育障碍的儿童的研究表明，通过胃造口术接受营养可以改善临床结果和生活质量。然而，关于胃造口术及其对神经肌肉疾病患者的影响的信息很少。对伦敦哈默史密斯医院的所有接受胃造口术的患者进行了回顾性病例审查，以评估胃造口术的适应症和结果。回顾了 32 名患者（17 名男性，15 名女性）的记录（年龄范围 32 岁至 31 岁；中位年龄 12 岁±5 个月）。我们发现了三组主要的诊断：先天性肌营养不良症 (n=15)、结构性先天性肌病 (n=11) 和其他神经肌肉疾病 (n=6)。在胃造口术之前确定了两种主要的喂养问题：吞咽困难以及营养和生长问题。胃造口术后随访时间为12个月至19年（平均5年）。根据现有数据，22 名患者中有 17 名体重下降，14 名患者中有 9 名身高下降。二十六名患者的胸部感染频率有所降低。没有记录胃造口术放置的明显并发症。二十八名患者或其家人对胃造口术的结果感到满意。胃造口术似乎对患有神经肌肉疾病和喂养困难的患者具有显着的积极影响。
Studies of children with neurodevelopmental disorders have shown that receiving nutrition through a gastrostomy can improve clinical outcomes and quality of life. However, there is little information on gastrostomy and its effect in patients with neuromuscular disorders. A retrospective casenote review of all patients with a gastrostomy, followed-up at the Hammersmith Hospital, London, was undertaken to assess the indications for, and outcomes of, gastrostomy placement. Notes for 32 patients (17 males, 15 females) were reviewed (age range 32mo-31y; median age 12y 5mo). We found three main groups of diagnoses: congenital muscular dystrophy (n=15), structural congenital myopathies (n=11), and other neuromuscular disorders (n=6). Two main patterns of feeding problems were identified before gastrostomy: swallowing difficulties, and nutrition and growth problems. The follow-up period after gastrostomy was from 12 months to 19 years (mean 5y). Weight faltering was reversed in 17 out of 22 patients, and height faltering in 9 out of 14, where data were available. Twenty-six patients had a reduced frequency of chest infections. No significant complication of gastrostomy placement was documented. Twenty-eight patients or their families were happy with the results of the gastrostomy. Gastrostomy seems to have a substantial positive impact in patients with neuromuscular disease and feeding difficulties.