• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Surgical Endoscopy >Late accidental dislodgement of a percutaneous endoscopic gastrostomy tube: an underestimated burden on patients and the health care system.
【24h】

Late accidental dislodgement of a percutaneous endoscopic gastrostomy tube: an underestimated burden on patients and the health care system.

机译：经皮内窥镜胃造口术管的意外意外移位：患者和卫生保健系统的负担被低估了。

获取原文
获取原文并翻译 | 示例
       
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

BACKGROUND: Since its introduction in 1980, the percutaneous endoscopic gastrostomy (PEG) tube has become an efficient means of providing long-term enteral access. Conveniently, the soft inner bumper allows PEG removal with relatively minimal external traction. Consequently, a major complication is accidental dislodgement, from which significant morbidity may occur. Clinicians have perhaps underestimated and underappreciated this complication, not only in the acute setting but over the lifetime of the PEG tube. METHODS: A retrospective analysis of PEG placements conducted at the authors' institution identified all PEG tubes placed between July 1, 2007 and July 1, 2010 by one faculty surgeon. Patient charts were reviewed for 30-day mortality, complications, and subsequent management. Patients were reviewed until intentional removal of the PEG, cessation of records, or patient mortality. RESULTS: A total of 563 PEGs were identified. The 30-day mortality rate was 7.8% (44/563), and the 7-day early accidental dislodgement rate was 4.1% (23/563). The total lifetime accidental PEG dislodgement rate was 12.8% (72/563). Of the 72 dislodged PEGs, 49 occurred after discharge from rehabilitation or nursing facilities. The vast majority required an emergency department visit, a level 3 surgical consultation, a replacement gastrostomy tube, and a radiographic confirmation of tube positioning, resulting in charges totaling an average of Dollars 1,200. CONCLUSION: Many large PEG reviews report an early accidental dislodgement rate of 0.6% to 4.0%. The most clinically significant accidental removals occur in the first 7 days after placement, and open gastrostomy may cause obvious morbidity. The early dislodgement rate in this study (4.1%) is consistent with those currently reported. However, if cases are followed longitudinally, a significantly higher rate of late dislodgement (12.8%) is seen. Frequently placed into neurologically impaired or elderly patients, the PEGs that dislodge months and years later require expensive management. The late removal complication and its associated costs are overlooked and underestimated.
机译：背景：自1980年问世以来，经皮内窥镜胃造口术（PEG）管已成为提供长期肠内通路的有效手段。方便的是，柔软的内部缓冲器可在相对较小的外部牵引力的情况下去除PEG。因此，主要的并发症是意外脱臼，从中可能会发生大量发病。临床医师可能不仅在急性环境中而且在PEG管的整个生命周期中都低估了这种并发症，并没有充分认识到这种并发症。方法：对作者所在机构进行的PEG放置进行回顾性分析，确定了2007年7月1日至2010年7月1日之间所有PEG导管均由一名外科医生放置。复查患者图表以了解30天的死亡率，并发症和后续处理。对患者进行检查，直到有意移除PEG，停止记录或患者死亡为止。结果：共鉴定出563种PEG。 30天死亡率为7.8％（44/563），而7天早期意外移位率为4.1％（23/563）。终生意外PEG脱落总率为12.8％（72/563）。在移出的72种PEG中，有49种发生在康复或护理机构出院后。绝大多数人需要急诊就诊，进行3级外科手术咨询，更换胃造口术导管以及对导管位置进行放射学确认，平均费用总计为1,200美元。结论：许多大型PEG审查报告称早期意外脱位率为0.6％至4.0％。临床上最重要的意外清除发生在放置后的前7天，开放性胃造口术可能会导致明显的发病率。该研究的早期脱位率（4.1％）与目前报道的一致。但是，如果纵向随访病例，则发现晚期脱位的比率明显更高（12.8％）。经常放置在神经功能障碍或老年患者中，数月和数年后脱落的PEG需要昂贵的管理费用。晚期切除并发症及其相关费用被忽视和低估了。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号