Efficacy of percutaneous endoscopic gastrostomy in pediatric patients / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze the efficacy of percutaneous endoscopic gastrostomy (PEG) in pediatric patients.</p><p><b>METHOD</b>From October 2011 to October 2014, children in the gastrointestinal ward of Guangzhou Women and Children's Medical Center received PEG or jejunal tube PEG(JET-PEG). The success rate, operation time were recorded. The changes of their weight, enteral nutrition calories and the incidence of pneumonia before and after the first 6 months of operation were compared. Follow-up was conducted until October 2014, the recent and long term complications, the length of indwelling time, the replacement or removal of the tube were recorded, the patients swallowing function or the primary disease's outcomes were observed.</p><p><b>RESULT</b>Of the 13 cases, 10 were male, 3 were female, their average age was 2 years (range 1.8 months-9 years). We performed PEG for 12 of the patients who had congenital craniofacial problems that led to feeding difficulties or recurrent cough and pneumonia (6/12), or neurological disorders (6/12) with inability to swallow, and in one case JET-PEG was performed, this child suffered from chronic intestinal pseudo-obstruction with vomiting and abdominal distension. The gastrostomy was successful in all the patients through one operation, the average operation time of PEG was (25 ± 3) minutes, JET-PEG was 60 minutes. One local skin infection was noted, no long-term complication occurred. In the first 6 months after operation, all the patients gained weight((5.5-30.5) kg postoperation vs. (3.0-30.0) kg preoperation), and 12 cases' enteral nutrition calories increased (from (209-502) to(272-543) kJ/(kg·d)), the incidence of pneumonia decreased in the children who had recurrent pneumonia before the operation (from (0-1.5) to (0-0.16) per month). Until October 2014, their average length of gastric tube indwelling time was 17.8 months (range 4-36 months). In 4 cases PEG tube was removed when they could eat completely independently, the other 9 needed enteral vein nutrition via PEG tube or jejunal tube, in 3 of them balloon type gastric fistula tube was applied. Two of the 13 cases who had cleft palate received stomatological operations when their weight grew to meet the standard.</p><p><b>CONCLUSION</b>PEG and JET-PEG are safe and effective method for enteric nutrition feeding in pediatrics, the technique causes minimal trauma and has rapid postoperative recovery, few complications, good aesthetic appearances and simple nursing, it can significantly improve their nutritional status and quality of life.</p>

Clinical study of blood-activating and stasis-resolving therapy (活血化瘀法) for patients with acute hypertensive cerebral hemorrhage small and moderate in amount and its influence on patients′ daily life ability / 中国中西医结合急救杂志

Objective: To observe blood-activating and stasis-resolving therapy (活血化瘀法)for patients with acute hypertensive cerebral hemorrhage small and moderate in amount and its influence on patients daily ability. Methods: One hundred and twenty-four cases were randomly divided into 3 groups: A group (n=52 cases), B group (n=34) and C group (n=38). Besides conventional therapies, A and B groups were treated additionally with 20 ml of Danshen injection (丹参注射液) in 5% glucose solution 250 ml for intravenous drip (once a day), 28 days constituting one therapeutic course, the beginning of the injection in A group was 24-48 hours after the attack and that of B group, 1 week after the attack. All the cases were evaluated by effective rate, neural defect score (NDS), ability of daily life (ADL), modified Barthel index (MBI), the duration for the absorption of intracranial hematoma, mortality, etc. The therapeutic effects of the 3 groups were compared after the treatment for 28 days, 3 months and 6 months. Results: The total significant effective rates in A group and B group were significantly better than that of C group (all P0.05). Conclusion: The early use of blood-activating and stasis-resolving therapy is effective for patients with acute hypertensive cerebral hemorrhage small and moderate in amount, it may promote the absorption of the intracranial hematoma, and improve the patients′ remote prognosis.