Merrick Susan, Harnden Sarah, Shetty Shishir, Chopra Preeti, Clamp Philip, Kapadia Suneil
Department of Nutrition and Dietetics, Royak Wolverhampton Hospitals NHS Trust, New Cross Hospital, Wolverhampton, UK.
JPEN J Parenter Enteral Nutr. 2008 Jan-Feb;32(1):78-80. doi: 10.1177/014860710803200178.
This study aimed to establish whether 15-Fr gauge percutaneous endoscopic gastrostomy (PEG) tubes can be safely removed by "cut and push."
Patients were prospectively recruited who were found to be without significant intestinal dysfunction requiring removal of Freka (Fresenius Kabi) 15-Fr gauge PEG tubes. The PEG tube was cut close to the stoma and the remnant pushed into the gastric lumen with a 14-Fr nasogastric tube. Patients were asked to observe their stool for the remnant. Patients were contacted at day 7 and an abdominal x-ray was arranged for those who had not seen the remnant in the stool. If the remnant was still present as seen on plain x-ray, the patient was contacted on day 14. A second x-ray was ordered if the patient reported that they had still not seen the remnant. Outcome measures were PEG remnant observed in stool or not seen on plain abdominal x-ray, and adverse events.
Forty-two patients were recruited over 29 months: 38 head and neck patients and 4 others (stroke, head injury, cystic fibrosis [CF], and lung cancer). Of these, 41 had passed the remnant by day 8 and all by day 14. No adverse events occurred.
We have concluded that cut and push is a safe method of removal for Freka 15-Fr PEG tubes in ambulant patients without significant gastrointestinal history.
本研究旨在确定15法式经皮内镜胃造口术（PEG）管能否通过“切割并推送”的方法安全移除。
前瞻性招募了因肠道功能无明显异常而需要移除Freka（费森尤斯卡比公司）15法式PEG管的患者。将PEG管在靠近造口处切断，并用14法式鼻胃管将剩余部分推送至胃腔内。要求患者观察粪便中是否有剩余部分。在第7天联系患者，对于粪便中未发现剩余部分的患者安排腹部X光检查。如果在普通X光片上仍可见剩余部分，则在第14天联系患者。如果患者报告仍未见到剩余部分，则再次安排X光检查。观察指标为粪便中是否观察到PEG剩余部分或腹部平片上是否未见剩余部分，以及不良事件。
在29个月内招募了42例患者：38例头颈部患者和4例其他患者（中风、头部受伤、囊性纤维化[CF]和肺癌）。其中，41例在第8天排出了剩余部分，所有患者在第14天均排出。未发生不良事件。
我们得出结论，对于无明显胃肠道病史的门诊患者，切割并推送是一种安全的Freka 15法式PEG管移除方法。
