天津医药

天津医药 ›› 2023, Vol. 51 ›› Issue (7): 687-689.doi: 10.11958/20230443

所属专题： 专题研究

• 专题研究·肌萎缩侧索硬化 • 上一篇    下一篇

CT引导下和内镜下经皮胃造瘘术对肌萎缩侧索硬化患者的疗效观察

廉羚1(), 林伟源2, 向贤宏2, 姚晓黎1,△()   

  1. 1 中山大学附属第一医院神经科，广东省重大神经疾病诊治研究重点实验室，国家临床重点专科和国家重点学科（邮编510080）
    2 中山大学附属第一医院放射介入科
  • 收稿日期:2023-03-27 修回日期:2023-04-12 出版日期:2023-07-15 发布日期:2023-06-20
  • 通讯作者: △姚晓黎 E-mail:yaoxiaol@mail.sysu.edu.cn
  • 作者简介:廉羚（1991），女，主治医师，主要从事肌萎缩侧索硬化及周围神经病方面研究。E-mail：lianling@mail.sysu.edu.cn
  • 基金资助:
    国家自然科学基金面上项目(82271448);广州市科技计划项目(SL2022A04J01813);广东省重大神经疾病诊治研究重点实验室(2020B1212060017);广东省神经系统疾病临床医学研究中心项目(2020B1111170002);华南神经疾病早期干预及功能修复研究国际联合研究中心项目(2015B050501003);华南神经疾病早期干预及功能修复研究国际联合研究中心项目(2020A0505020004);广东省神经系统重大疾病诊治工程技术研究中心;广东省神经系统重大疾病诊治转化医学创新平台和广州市神经系统重大疾病临床医学研究与转化中心项目(201604020010)

Clinical observation of CT-guided and endoscopic percutaneous gastrostomy in patients with amyotrophic lateral sclerosis

LIAN Ling1(), LIN Weiyuan2, XIANG Xianhong2, YAO Xiaoli1,△()   

  1. 1 Department of Neurology, the First Affiliated Hospital, Sun Yat-Sen University; Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou 510080, China
    2 Department of Interventional Radiology, the First Affiliated Hospital, Sun Yat-Sen University
  • Received:2023-03-27 Revised:2023-04-12 Published:2023-07-15 Online:2023-06-20
  • Contact: △YAO Xiaoli E-mail:yaoxiaol@mail.sysu.edu.cn

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摘要：

目的 比较CT引导下和内镜下经皮胃造瘘术在肌萎缩侧索硬化（ALS）患者中的临床应用效果。方法 104例ALS患者中48例行CT引导下经皮胃造瘘术（CT引导组），56例行内镜下经皮胃造瘘术（内镜组）。比较2组患者的疾病情况、住院时间、术后住院时间、术后并发症情况以及术后半年及1年生存率。结果 2组患者年龄、病程、吞咽困难时间、身高、体质量、术前营养状况差异无统计学意义（P>0.05）。CT引导组患者住院时间和术后住院时间较内镜组缩短（P<0.05）。内镜组并发症发生率（19.6%）和CT引导组（8.3%）比较差异无统计学意义（P>0.05）。内镜组与CT引导组术后1年生存率差异均无统计学意义（91.0% vs. 93.8%，Log-rank χ2=1.606，P>0.05）。结论 CT引导下经皮胃造瘘术在缩短ALS患者住院时间及术后住院时间方面具有明显优势，值得临床广泛推广。

关键词: 肌萎缩侧索硬化, 经皮胃造瘘, 吞咽困难, 并发症, 住院时间

Abstract:

Objective To compare the clinical effects of CT-guided and endoscopic surgical percutaneous gastrostomy in patients with amyotrophic lateral sclerosis (ALS). Methods The clinical data of 104 patients with ALS were retrospectively analyzed, including 48 patients underwent CT-guided percutaneous gastrostomy (CT-guided group) and 56 patients underwent endoscopic percutaneous gastrostomy (endoscopic group). The disease status, length of hospital stay, postoperative length of hospital stay, postoperative complications, and survival rates of six months and one year after surgery were compared between the two groups. Results There were no significant differences in age, disease course, dysphagia time, height, body weight and preoperative nutritional status between the two groups (P>0.05). The length of hospital stay and postoperative length of stay were shorter in the CT-guided group than those in the endoscopic group (P<0.05). There was no significant difference in the incidence of complications between the endoscopic group (19.6%) and the CT-guided group (8.3%, P>0.05). There was no significant difference in one-year survival rate between the endoscopic group and the CT-guided group (91.0% vs. 93.8%, Log-rank χ2=1.606, P>0.05). Conclusion CT-guided percutaneous gastrostomy shows its advantages in ALS, especially in shortening the length of hospital stay and postoperative length of hospital stay in ALS patients, and is worthy of widespread clinical application.

Key words: amyotrophic lateral sclerosis, percutaneous gastrostomy, dysphagia, complications, length of hospital stay

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