2003 Volume 12 Issue 11 Pages 729-736
In this report, we have evaluated the efficacy of percutaneous endoscopic gastrostomy (PEG) nutrition for senile patients with cerebrovascular disease compared with IVH and naso-gastric tube nutrition. Ninety-four patients over the age of 70 with cerebrovascular disease have a malnutritional condition because of dysphagia, hemiparesis, bulbar paresis, and dementia. They were fed using PEG operated by push method. As operative complication in PEG insertion, post operative bleeding, pulling out the tube by themselves, local infection and pneumonia due to dysswallowing were revealed. The serum albumin levels of patients fed using PEG were 2.7 g/dl on admission and 3.3 g/dl at 8 weeks after PEG nutrition (group A). Those of patients with IVH nutrition (group B) were 2.9 and 3.0 g/dl. Those of patients with naso-gastric tube nutrition (group C) were 2.9 and 3.0 g/dl. The incidences of decubitus were 18.1%, 31.9%, and 22.2% in group A, B, and C. Our results showed 29.8%, 22.2%, and 14.3% improvements in swallowing function in group A, B, and C. Activities of daily living (ADL) of patients with PEG nutrition were 15.4 on admission and 65.4 at 6 months after PEG nutrition. PEG nutrition contributed to the improvement for ADL, especially for feeding activity and toileting. We conclude here that PEG is a reliable nutrition method for aged patients with cerebrovascular disease compared to previous intravenous hypernutrition and naso-gastric tube nutrition.
