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目的探讨脑卒中后吞咽障碍患者经皮内镜下胃造瘘(percutaneous endoscopic gastrostomy,PEG)行肠内营养的效果。方法 68例脑卒中后吞咽障碍患者根据肠内营养的方式不同分为PEG组(34例)和鼻胃管(nasogastric tube,NGT)组(34例)。比较两种肠内营养途径的相关并发症及营养改善效果。结果 PEG组与NGT组比较,PEG组胃潴留(14.7%vs.32.4%),反流性食管炎(11.8%vs.23.5%),吸入性肺炎(17.6%vs.38.2%)均较NGT组显著降低(P<0.05);PEG组营养治疗3个月的BMI[(20.56±1.32)kg/m2 vs.(19.97±1.35)kg/m~2],ALB[(40.45±2.12)g/L vs.(38.27±2.25)g/L],前白蛋白(PA)均高于NGT组[(302.12±30.28)mg/L vs.(280.27±28.17)mg/L],差异均有统计学意义(P<0.05)。结论脑卒中后吞咽障碍患者PEG行肠内营养是一种安全、有效的营养支持方法,促进疾病康复,提高患者生活质量。
Objective To investigate the effect of percutaneous endoscopic gastrostomy (PEG) on enteral nutrition in patients with post-stroke dysphagia. Methods Sixty-eight patients with post-stroke dysphagia were divided into PEG group (34 cases) and nasogastric tube group (34 cases) according to the way of enteral nutrition. Compare the complications of the two enteral nutrition and the effect of nutrition improvement. Results Compared with the NGT group, the gastric perfusion in the PEG group (14.7% vs.32.4%), reflux esophagitis (11.8% vs.23.5%) and aspiration pneumonia (17.6% vs.38.2% (P <0.05); BMI [(20.56 ± 1.32) kg / m 2 vs (19.97 ± 1.35) kg / m 2] and ALB [(40.45 ± 2.12) g / L (38.27 ± 2.25) g / L], prealbumin (PA) were significantly higher than those in NGT group [(302.12 ± 30.28) mg / L vs. (280.27 ± 28.17) mg / L] (P <0.05). Conclusion PEG in patients with post-stroke dysphagia enteral nutrition is a safe and effective nutritional support to promote disease recovery and improve the quality of life of patients.