摘要
目的评价经皮内镜胃造瘘空肠置管术(PEG-J)在反复吸入性肺炎患儿肠内营养中应用疗效。方法纳入2013年1月至2018年3月在浙江大学医学院附属儿童医院消化科行PEG-J的12例患儿。分析患儿的PEG-J手术并发症、肠内营养并发症,以及术后营养状况、原发疾病转归和拔管情况等。结果12例患儿行PEG-J,其中男8例、女4例,平均年龄1岁5月龄(4月龄至6岁1月龄)。手术前平均病程7月龄(2月龄至2岁),所有患儿均存在反复吸入性肺炎,其中9例(75%)患儿生后就出现喂养障碍伴反复吸入性肺炎,合并重度营养不良4例(33.3%),中度营养不良3例(25.0%)。所有患儿手术均1次取得成功。3例(25%)出现手术相关的近期并发症。2例(16.7%)出现营养管相关并发症。在行PEG-J行空肠肠内营养后,11例患儿基本未发生吸入性肺炎,1例患儿(球麻痹合并胃食管反流患儿)吸入性肺炎发作次数明显减少。肠内营养前后年龄别体重Z评分显著增高(P<0.05),年龄别身高Z评分显著增高(P<0.05)。结论PEG-J可用于反复吸入性肺炎患儿的肠内营养治疗,不仅可以减少吸入性肺炎的发作次数,改善营养状态,同时具有副反应少、并发症少以及适用于长期肠内营养支持治疗的优点。
ObjectiveTo evaluate the efficacy of PEG-J in enteral nutrition for children with recurrent aspirationpneumonia.MethodsTotally 12 cases who underwent PEG-J in our center from January 2013 to March 2018.Thechildren were analyzed for surgical complications,enteral nutrition complications,postoperative nutritional status of thechildren,outcome of the primary disease,and extubation.ResultsA total of 12 children underwent PEG-J,including8 males and 4 females,with an average age of 1 year and 5 months(4 months-6 years and 1 month).The meanduration of the disease before surgery was 7 months(2-24 months),and all the children had recurrent aspirationpneumonia,9 cases(75%)of which had feeding disorders after birth accompanied by recurrent aspiration pneumonia,4 cases(33.3%)with severe malnutrition,and 3 cases(25.0%)with moderate malnutrition.The PEG-J was successful inall the patients through one operation.Three(25%)of the children presented surgery-related recent complications.Nutritional tube-related complications occurred in 2 cases(16.7%).After jejunal enteral nutrition with PEG-J,11 patients with aspiration pneumonia were improved significantly,and in 1 patient(ball palsy with gastroesophageal refluxdisease)the number of aspiration pneumonia attacks was significantly reduced.The Z-score of age-body weight for agebefore and after enteral nutrition was significantly increased(P<0.05),and the height for age Z score was significantlyhigher(P<0.05).ConclusionPEG-J is safe and effective in enteral nutrition treatment for children with recurrentaspiration pneumonia.It can not only reduce the number of episodes of aspiration pneumonia,improve nutritionalstatus,but also has fewer side effects and fewer complications.It can be used for long-term enteral nutrition support treatment.
作者
赵泓
楼金玕
余金丹
罗优优
彭克荣
江丽琴
陈洁
ZHAO Hong;LOU Jin-gan;YU Jin-dan;CHEN Jie(Department of Gastroenterology,Children’s Hospital of Zhejiang University School of Medicine,Hangzhou 310052,China)
出处
《中国实用儿科杂志》
CSCD
北大核心
2020年第10期792-795,共4页
Chinese Journal of Practical Pediatrics
关键词
儿童
吸入性肺炎
营养不良
肠内营养
自然腔道内镜手术
child
aspiration pneumonia
malnutrition
enteral nutrition
natural lumen endoscopic surgery
