| 石青青,刘文国,徐青.脑卒中严重吞咽障碍患者PEG置管生存状态的分析[J].中国康复,2025,40(9):525-529 |
| 脑卒中严重吞咽障碍患者PEG置管生存状态的分析 |
| Analysis of survival status in stroke patients with severe dysphagia following PEG tube placement |
| |
| DOI：10.3870/zgkf.2025.09.003 |
| 中文关键词: 经皮内镜下胃造瘘术 脑卒中 吞咽障碍 生存分析 |
| 英文关键词: percutaneous endoscopic gastrostomy stroke dysphagia survival analysis |
| 基金项目: |
|
| 摘要点击次数: 493 |
| 全文下载次数: 284 |
| 中文摘要: |
| 目的：探讨经皮内镜下胃造瘘术（PEG）对脑卒中严重吞咽障碍患者生存状态的影响因素，为优化临床管理提供依据。方法：本研究为我院进行的单中心回顾性队列研究，纳入了2010年10月～2022年10月期间，首次接受PEG置管术的122例患者。收集了人口学特征、卒中类型、住院时间、PEG管是否留置和生存状态。采用单因素和多因素Logistic回归分析评估死亡风险的独立预测因素。结果：122例患者中位随访时间为38.5个月，其中79例（64.8%）生存，43例（35.2%）死亡。单因素分析显示，与生存组相比，死亡组患者年龄显著更高（P<0.01），而中位住院天数则显著更短（P＝0.03）。此外，死亡组的营养不良、肉芽组织形成、反流及肺炎等并发症发生率均显著高于生存组（均P<0.05）。多因素Logistic回归分析显示，与脑出血相比，脑梗死是生存的独立保护因素（OR=0.16, 95% CI: 0.05~0.56, P=0.004）；较长的住院天数同样是生存的独立保护因素（OR=0.98, 95% CI: 0.96~0.99, P=0.013）。高龄是死亡的独立危险因素（OR=1.08, 95% CI: 1.03~1.14, P=0.001）。与持续留置PEG管相比，拔除PEG管的患者生存率显著更高（OR=175.04, 95% CI: 20.03~1529.38, P<0.001）。结论：脑卒中类型、住院时间及年龄是影响PEG术后患者生存的重要因素。吞咽功能恢复并成功拔除PEG管与患者长期生存显著相关，提示功能恢复是改善预后的关键。 |
| 英文摘要: |
| Objective:To investigate factors influencing survival status in stroke patients with severe dysphagia following percutaneous endoscopic gastrostomy (PEG), thereby providing evidence for optimizing clinical management. Methods:This single-center retrospective cohort study was conducted at Beijing Bo’ai Hospital, China Rehabilitation Research Center. The study included 122 patients who underwent initial PEG tube placement between October 2010 and October 2022. Demographic characteristics, stroke type, length of hospitalization, PEG tube retention status, and survival status were collected. Univariate and multivariate logistic regression analyses were performed to evaluate independent predictors of mortality risk. Results:The median follow-up period was 38.5 months (IQR 19.0-57.5). During the follow-up period, 43 patients (35.2%) died and 79 (64.8%) survived. Univariate analysis showed that the deceased patient group was significantly older (P<0.001) and had a significantly shorter median hospital stay (P=0.003) than the surviving group. Complications such as malnutrition, granulation tissue formation, reflux, and pneumonia were significantly more prevalent in deceased patients (all P<0.05). Multivariate logistic regression analysis revealed that ischemic stroke (compared to hemorrhagic stroke) (OR=0.16, 95% CI: 0.05-0.56, P=0.004) and longer hospitalization (OR=0.98, 95% CI: 0.96-0.99, P=0.013) were independent protective factors for survival. Advanced age was an independent risk factor for mortality (OR=1.08, 95% CI: 1.03-1.14, P=0.001). PEG tube removal was associated with significantly higher survival rates than continued retention (OR=175.04, 95% CI: 20.03-1529.38, P<0.001). Conclusion:Stroke type, length of hospitalization, and age are important factors affecting survival in post-PEG patients. Recovery of swallowing function, leading to PEG tube removal, is strongly associated with improved long-term survival, highlighting functional recovery as a key determinant of prognosis. |
|
查看全文
下载PDF阅读器 HTML全文 |
| 关闭 |
|
|
|
