经皮内镜下胃造口管及鼻饲管在克罗恩病肠内营养支持中的疗效比较

摘要

Objective To compare the clinical efficacy of percutaneous endoscopic gastrosto-my(PEG)and nasogastric feeding tube in the treatment of Crohn’s disease patients with malnutrition. Methods Clinical materials of 45 patients underwent enteral nutrition for CD from 2007 to 2013 were analyzed,and they were divided into PEG group (n =24)and nasogastric feeding group (n =21 ). Results The rate of tube-associated complications was 16.67% in the PEG group, which was significantly lower than 4 7 .6 2 % in the nasogastric feeding group (χ2 =5 .0 0 7 ,P =0 .0 2 5 ).There was no significant difference of nutrition improvement between the two group (P >0.05).One month after treatment,IBDQ score in the PEG group was significantly higher than that in the nasogastric feeding group (P <0.05 ).Conclusion PEG is a safe,effective and comfortable method for CD patients who need to be treated with a long-term enteral nutrition.%目的：比较经皮内镜下胃造口管（PEG）及鼻饲管在克罗恩病肠内营养支持中的疗效。方法分析2007年1月-2013年1月在本院接受治疗的45例克罗恩病合并营养不良患者的临床资料，并分为 PEG 组24例和鼻饲组21例。结果PEG 组患者管饲并发症发生率为16．67％，显著低于鼻饲组的47．62％，差异有统计学意义（χ2＝5．007，P ＝0．025）。治疗前2组患者相关营养学指标比较差异无统计学意义；治疗后2组患者在血白蛋白、前白蛋白、上臂围、上臂肌围、三头肌皮褶厚度及 BMI 上比较差异均无统计学意义（P ＞0．05）；治疗后1个月，2组患者 IBDQ 均较同组治疗前显著升高（P ＜0．05），且鼻饲组治疗后 IBDQ 显著低于 PEG 组（P ＜0．05）。结论在克罗恩病的肠内营养支持中，PEG 途径安全、有效，较传统的鼻饲途径具有管饲并发症发生率低、生活质量高等优势。