经皮内镜下胃造口术在甲基丙二酸血症/丙酸血症合并喂养困难中的应用评估:7例病例分析OA

Objective To evaluate the efficacy and safety of percutaneous endoscopic gastrostomy(PEG)in children with methylmalonic acidemia(MMA)or propionic acidemia(PA)complicated by feeding difficulties.Methods Clinical data of seven children with MMA/PA and feeding difficulty who underwent PEG at Shenzhen Maternity and Child Healthcare Hospital from June 2021 to April 2025 were retrospectively analyzed.Preoperative assessment,perioperative management,and postoperative follow-up were summarized.Results The median age at PEG placement was 20 months.All PEG placements were successfully completed in a single attempt.The mean operative time was(21.0±2.2)minutes,intraoperative blood loss was 1-2 mL,and the mean postoperative hospital stay was(5.7±1.1)days.At 6 months postoperatively,compared with preoperative values,body weight and length increased,the frequency of acidosis episodes decreased,daily feeding time was shortened,time spent on outdoor activities increased,and serum prealbumin levels rose(all P<0.05).During 6-12 months of follow-up,the most common complication was peristomal hypergranulation(five cases).One case developed gastrostomy-site perforation 7 months postoperatively.Conclusions PEG effectively improves nutritional and metabolic status in children with MMA/PA complicated by feeding difficulties and is a safe,effective method for long-term enteral nutrition support.