拉出法与插入法经皮内镜下胃造瘘术在口腔颌面部恶性肿瘤患者中的应用效果比较

目的: 比较拉出法与插入法经皮内镜下胃造瘘术（percutaneous endoscopic gastrostomy,PEG）在口腔颌面部恶性肿瘤患者中的应用效果。方法: 收集 2018年1月—2020年12月于上海交通大学医学院附属第九人民医院行PEG的113例患者的相关资料,包括年龄、性别、PEG方式、术后并发症情况。根据PEG操作技术将患者分为2组,分别采用拉出法（Pull-PEG组）和插入法（Intro-PEG组）进行PEG,比较2种操作技术的优缺点。采用SPSS 20.0软件包对数据进行统计学分析。结果: 2组患者的年龄、性别和白蛋白水平相似,Intro-PEG组中患者的肿瘤分期较高,Karnofsky评分较低,但差异无统计学意义。总体并发症发生率为8.8%,其中局部并发症发生率为6.2%,全身并发症发生率为2.7%。Pull-PEG组患者75例,术后发生并发症7例（9.3%）;Intro-PEG组患者38例,术后发生并发症3例（7.9%）;2组差异无统计学意义（P>0.05）。结论: 对于需要营养支持的口腔颌面部恶性肿瘤患者,拉出法和插入法均是操作简便、安全易行、并发症少的PEG方式。

Comparison of pull and introducer percutaneous endoscopic gastrostomy techniques in patients with the oral and maxillofacial malignancies

PURPOSE: The aim of this study was to compare pull and introducer percutaneous endoscopic gastrostomy(PEG) technique in patients with oral and maxillofacial malignancies(OMM). METHODS: This study was based on a retrospective analysis of 113 patients with OMM who underwent PEG in our hospital from January 2018 to December 2020, including age, gender, complications, etc. The patients were divided into two groups according to manipulation technique of PEG, namely Pull-PEG group and Intro-PEG group. SPSS 20.0 software package was used to compare the advantages and disadvantages of the two PEG techniques. RESULTS: Age, sex and albumin levels were similar in both groups. Patients in the Intro-PEG group had higher tumor stage and lower Karnofsky scores, but the difference was not statistically significant. The overall complication rate was 8.8%, including 6.2% of local complications and of 2.7% systemic complications. Postoperative complications occurred in 7 of the 75 patients (9.3%) in the Pull-PEG group and 3 of the 38 patients (7.9%) in the Intro-PEG group. Overall, major, minor, immediate and late complications were similar in both groups (P>0.05). CONCLUSIONS: Pull and introducer PEG technique seem to be both safe and effective but present different complication profiles for patients with oral and maxillofacial malignancies.