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为谁谋利?PEG 喂养。

Cui bono? PEG feeding.

机构信息

Royal Hallamshire Hospital, Sheffield, UK

Royal Hallamshire Hospital, Sheffield, UK.

出版信息

Clin Med (Lond). 2021 Jan;21(1):e2-e4. doi: 10.7861/clinmed.2020-0759.

Abstract

Percutaneous endoscopic gastrostomy (PEG) provides long-term nutritional support to those unable to tolerate intake orally. The benefits of a PEG depend on the indication and the individual, and are considered when it has the potential to improve mortality, nutritional status or quality of life. Often, family members and healthcare professionals have to act on behalf of the patient. It is difficult for their personal values and emotions to not be a factor when deciding if to proceed with a PEG. This may result in unnecessary PEG placement. For certain indications (dementia for example), there is limited evidence of any benefits a PEG may give and may actually cause harm. Guidance to improve patient selection and increase education for healthcare professionals is essential in achieving the best outcome for the patient.

摘要

经皮内镜胃造口术(PEG)为无法经口摄入营养的患者提供长期营养支持。PEG 的益处取决于适应证和个体情况,当它有可能改善死亡率、营养状况或生活质量时,才会考虑使用 PEG。通常,家属和医疗保健专业人员需要代表患者做出决定。在决定是否进行 PEG 时,他们的个人价值观和情感很难不成为一个因素。这可能导致不必要的 PEG 置管。对于某些适应证(例如痴呆),PEG 可能带来的益处证据有限,实际上可能会造成伤害。为了实现患者的最佳预后,有必要提供指导以改善患者选择,并加强对医疗保健专业人员的教育。

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本文引用的文献

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Mortality among patients who receive or defer gastrostomies.接受或推迟胃造口术的患者的死亡率。
Clin Gastroenterol Hepatol. 2013 Nov;11(11):1445-50. doi: 10.1016/j.cgh.2013.04.025. Epub 2013 Apr 29.
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Feeding tubes and the prevention or healing of pressure ulcers.饲管与压疮的预防或愈合
Arch Intern Med. 2012 May 14;172(9):697-701. doi: 10.1001/archinternmed.2012.1200.

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