Investigation and prediction of enteral nutrition problems after percutaneous endoscopic gastrostomy

作     者：Shiro Yokohama Masaru Aoshima Yukiomi Nakade Junya Shindo Junichi Maruyama Masashi Yoneda 

作者机构：Department of GastroenterologyAsahikawa Rehabilitation HospitalAsahikawa078-8801Japan Division of Gastro-enterologyDepartment of Internal MedicineAichi Medical University School of MedicineAichi 480-1195Japan Department of RehabilitationAsahikawa Rehabilitation HospitalAsahikawa 078-8801Japan Department of Internal MedicineAsahikawa Rehabilitation HospitalAsahikawa 078-8801Japan 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2009年第15卷第11期

页      面：1367-1372页

核心收录：

学科分类：1002[医学-临床医学] 100215[医学-康复医学与理疗学] 10[医学] 

主　　题：经皮内镜下胃造瘘术 全肠内营养 营养问题 预测因素 Logistic回归分析 麻痹性肠梗阻 慢性肾功能不全 聚乙二醇 

摘      要：AIM:To investigate and predict enteral nutrition problems after percutaneous endoscopic gastrostomy (PEG). METHODS:We retrospectively analyzed data for 252 out of 285 patients who underwent PEG at our hospital from 1999 to 2008.Enteral nutrition problems after PEG were defined as:(1)patients who required ≥1 mo after surgery to switch to complete enteral nutrition,or who required additional parenteral alimentation continuously;or(2)patients who abandoned switching to enteral nutrition using the gastrostoma and employed other nutritional methods. We attempted to identify the predictors of problem cases by using a logistic regression analysis that examined the patients’backgrounds and the specific causes that led to their problems. RESULTS:Mean age of the patients was 75 years,and in general,their body weight was low and their overall condition was markedly poor.Blood testing revealed that patients tended to be anemic and malnourished.A total of 44 patients(17.5%)were diagnosed as having enteral nutrition problems after PEG.Major causes ofthe problems included pneumonia,acute enterocolitis (often Clostridium difficile-related),paralytic ileus and biliary tract infection.A multivariate analysis identified the following independent predictors for problem cases:(1)enteral nutrition before gastrectomy(a risk reduction factor);(2)presence of esophageal hiatal hernia;(3)past history of paralytic ileus;and(4) presence of chronic renal dysfunction. CONCLUSION:Enteral nutrition problems after PEG occurred at a comparatively high rate.Patient background analysis elucidated four predictive factors for the problem cases.