Friginal-Ruiz Ana Belén, Lucendo Alfredo J
Ana Belén Friginal-Ruiz, RN, is Gastrointestinal Endoscopy Nurse, Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain. Alfredo J. Lucendo, PhD, MD, FEBGH, is Department Head, Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain.
Gastroenterol Nurs. 2015 Sep-Oct;38(5):354-66; quiz 367-8. doi: 10.1097/SGA.0000000000000150.
Percutaneous endoscopic gastrostomy (PEG) feeding represents the most effective and safest option for feeding patients with an impaired or diminished swallowing ability, despite having a functioning digestive system. The use of PEG has evolved to be useful in many situations beyond degenerative neuromuscular disorders, with an increasing body of evidence supporting the advantages of PEG tubes in oncologic and pediatric patients. Risk factors for complications after PEG tube placement include acute and chronic conditions associated with malnutrition and several organic disorders. Patients suitable for PEG tube placement should be individually identified to implement the advantages of this technique while minimizing risk events. The safety of placing a PEG tube in patients under antithrombotic medication has been investigated, as well as the advantages of antibiotic prophylaxis in reducing peristomal infection. Evidence supports the safety of early feeding after placement, thus resulting in lower costs. Percutaneous endoscopic gastrostomy-related complications are rare and mostly prevented by appropriate nursing care. Best medical practice and nursing care will ensure optimal performance leading to a wider acceptance, and greater utility of PEG by healthcare professionals, patients, and caregivers. This review aims to update knowledge relating to PEG tube indications, placement, management, and care in order to reinforce PEG feeding as the most valuable access for patients with a functional gastrointestinal system who have abnormalities in swallowing mechanisms.
经皮内镜下胃造口术（PEG）喂养是吞咽能力受损或下降但消化系统功能正常的患者最有效、最安全的喂养方式。尽管PEG的应用已不仅局限于退行性神经肌肉疾病，越来越多的证据支持PEG管在肿瘤患者和儿科患者中的优势。PEG管置入术后并发症的危险因素包括与营养不良相关的急慢性疾病和一些器质性疾病。应个体化确定适合PEG管置入的患者，以发挥该技术的优势，同时将风险事件降至最低。人们已经对正在接受抗血栓治疗的患者置入PEG管的安全性进行了研究，也探讨了预防性使用抗生素在减少造口周围感染方面的优势。有证据支持置入后早期喂养的安全性，从而降低成本。经皮内镜下胃造口术相关并发症很少见，大多可通过适当的护理预防。最佳医疗实践和护理将确保最佳效果，使医疗专业人员、患者和护理人员更广泛地接受PEG，并提高其效用。本综述旨在更新有关PEG管适应证、置入、管理和护理的知识，以强化PEG喂养作为吞咽机制异常但胃肠系统功能正常的患者最有价值的营养通路的地位。
