Objective To evaluate the safety and effertiveness of percutaneous gastrostomy (PRG) and gastrojejunostomy (PRGJ) under fluoroscopic guidance, and to discuss its technic:al manipulation. the indications and contraindications as well as the complications. Methods During the period f'rom May 2002 to June 2010 in authors ' hospital fluoroscopically-guided PRG or PRGJ was carried out in 40 patients. The clinical data were retrospectively analyzed. With Seldinger technique and under fluoroscopic guitlance, a 14 F radiopaque gastrostomy or gastrojejunostomy feeding catheter was successfully placed. The indications, operation procedures, clinical success rate, predure-related complications, and tube indwelling< time. etc. were discussed and analyzed. Results PRG was conducted in 30 patients. The reasons for performing PRG included neurologic disease (n = 13), recurrent aspiration pneurmonia (n = 6), gastroesophageal reflux due to disfunction of gastrointestinal tract (n = 3) , suhtotal gastrectomy (n =2), esophagomediastinal fistula (n = 1) and esophageal carcinoma (n = 5). PRGJ was carried out in 10 patients. The disorders included bulbar paralysis (n = 3) , malignant duodenal obstruction ( n = 4) and previous gastrostomy-related complications (n = 3). Two anchors were used in all patients receiving PRG or PRCJ. Clinical success was achieved in all study patients. No procedure-related or severe complications occurred. Minor complications were observed in four patients (10 ％). which included local soft tissue infection (n = 1). severe puncture site pain (n = 1), gastrostomy tube dislodgement (n = 1) and obstruction of gastrojejunostomy tube. (n = 1). During the follow-up period, no aggravation of gastroesophageal reflux or aspiration pneumonia was observed in all patients. The tube indwelling time was 115 to 585 days (mean of 150 days) after tube placement. Conclusion Fluoroscopically-guided percutaneous gastrostomy or gastrojejunostormy is a safe . simple and minimallv-invasive technique. This technique is effective and suitable for clinical enteral nutrition support therapy as well as for upper gastrointestinal tract decompression treatment. (J Intervent Radiol, 2011 , 20 : 279-282)%目的 评估经皮透视引导下胃造瘘和胃空肠造瘘术的临床应用,探讨影像导引下置管的技术操作及其适应证、禁忌证和并发症.方法 回顾性分析2002年5月 - 2010年6月在我院实施透视引导下胃造瘘和胃空肠造瘘术的40例患者的临床资料.采用Seldinger技术造痿,成功置入饲养管.分析手术指征,操作过程,技术成功率,手术相关并发症和饲养管留置时间.结果 经皮透视引导下实施胃造瘘术30例,其中神经系统疾病13例,反复发作性吸入性肺炎6例,胃肠道功能紊乱引起胃食管反流3例,胃大部切除术2例,食管纵隔瘘1例及食管癌5例.经皮透视引导下实施胃空肠造瘘术10例,其中球麻痹3例,恶性十二指肠梗阻4例及外科胃造口术后并发症3例.所有患者均使用2个锚型固定器.技术成功率100%.未发生术中置管相关并发症及术后严重并发症,轻微并发症发生率10%,包括局部软组织感染1例,穿刺部位疼痛1例,胃造瘘管移位1例及胃空肠造瘘管阻塞1例.在随访过程中未出现胃食管反流或吸入性肺炎加重等异常.饲养管留置时间是115 ～ 585 d (平均150 d).结论 经皮透视引导下胃造瘘和胃空肠造瘘术是安全,简单,有效的微创治疗,适用于肠内营养支持和胃肠减压.
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