目的: 分析经皮胃造瘘术（percutaneous gastrostomy, PG）在食管梗阻病人中的应用。方法: 收集2016年9月至2019年9月,在我院因食管梗阻行胃造瘘术病人的临床资料。比较PG与开腹胃造瘘（open gastrostomy, OG）的手术时间、术中出血量、术后疼痛评分（第2、60天）、术后营养启动时间、术后住院时间、60 d并发症发生率、术后第60天体重及血清白蛋白。结果: 共纳入39例,其中12例PG,27例OG,两组病例的基线数据差异无统计学意义（P>0.05）。PG手术时间和出血量分别为（24.6±9.9） min和（8.8±3.0） mL,明显低于OG（61.9±9.1） min（P<0.001）和（26.0±7.8） mL（P<0.001）。PG术后第2天和术后第60天疼痛评分分别为1.60±0.50和0.75±0.50,明显低于OG术后的2.3±0.8（P=0.008）和2.0±0.5（P<0.001）。PG的术后营养启动时间和住院时间分别为（18.8±4.6） h和（2.8±1.0） d;明显少于OG组的（64.3±15.7） h（P<0.001）和（4.4±1.2） d（P<0.001）。OG组有2例失访,PG组和OG组并发症发生率分别为8.3%（1/12）和24.0%（6/25）,两组间差异无统计学意义（P=0.389）。PG组术后第60天的体重和血清白蛋白与术前相比增加值分别为（0.6±0.8） kg和（1.3±0.9） g/L,OG组分别为（0.3±0.7） kg和（-0.1±1.3） g/L,两组血清白蛋白增加值差异有显著统计学意义（P<0.001）。结论: PG是一项安全、有效的微创技术,围术期多项指标均优于OG,可在食管梗阻病人中推广应用。

Objective: To analyze the application of percutaneous gastrostomy(PG) in patients with esophageal obstruction. Methods: The clinical data of patients undergoing gastrostomy for esophageal obstruction in our hospital from September 2016 to September 2019 were collected. Operative time, intraoperative blood loss, 2-day and 60-day postoperative pain test scores, beginning time of postoperative nutrition support, postoperative length of stay, 60-day morbidity, 60-day postoperative both body weight and serum albumin were compared between PG group and open gastrostomy (OG) group. Results: A total of 39 patients were studied including 12 cases with PG and 27 cases with OG. There was no signi-ficant difference in baseline data between two groups (P>0.05). The operative time and blood loss were (24.6±9.9) min and (8.8±3.0) mL in PG group respectively, which were significantly lower than those [(61.9±9.1) min and (26.0 ±7.8) mL] in OG group (P<0.001, P<0.001). The 2-day and 60-day postoperative pain scores were 1.60±0.50 and 0.75 ±0.50 in PG group respectively, lower significantly than those [(2.3±0.8) and (2.0 ±0.5)] in OG group (P=0.008, P<0.001). Beginning time of postoperative nutrition support [(18.8±4.6) h] and length of stay [(2.8±1.0) d] in PG group were significantly less than those [(64.3±15.7) h and (4.4±1.2) d] in OG group (P<0.001, P<0.001). Two cases lost follow-up in OG group. There was morbidity 8.3% (1/12) in PG group and 24.0% (6/25) in OG group respectively with no significant difference (P=0.389). The increase in 60-day postoperative body weight was (0.6±0.8) kg in PG group and (0.3 ±0.7) kg in OS group. There was significant difference of increase in 60-day postoperative serum albumin between PG group [(1.3±0.9) g/L] and OG group [(-0.1±1.3) g/L] (P<0.001). Conclusions: PG is minimally invasive and safe and effective with perioperative advantage when compared with OG and could be widely applied in patients with esophageal obstruction.