Choi In Hyoung, Cho Yu Kyung
Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea.
Brain Neurorehabil. 2022 Mar 28;15(1):e2. doi: 10.12786/bn.2022.15.e2. eCollection 2022 Mar.
Percutaneous endoscopic gastrostomy (PEG) is considered in patients with insufficient oral intake who need enteral feeding or therapeutic gastric decompression. PEG tube feeding is generally superior to nasogastric tube feeding in terms of patients' comfort, long-term use, and feeding efficiency. Patient selection for PEG, the proper endoscopic insertion technique, early recognition of complications, and appropriate management are important for patient care. During preparation, adequate management of anticoagulation and antithrombotic agents are important to prevent bleeding, and prophylactic antibiotics prevent wound infection. Most complications are minor; however, major complications that require surgical correction or are life-threatening may occur, such as wound infection, bleeding, buried bumper syndrome, colocutaneous fistula, perforation, volvulus, and injuries to other organs. This review presents practical guidelines for the selection and preparation of patients, endoscopic insertion methods, and complication management strategies.
经皮内镜下胃造口术(PEG)适用于需要肠内营养或治疗性胃减压但经口摄入不足的患者。在患者舒适度、长期使用及喂养效率方面,PEG管饲法通常优于鼻胃管饲法。PEG的患者选择、正确的内镜插入技术、并发症的早期识别及恰当处理对患者护理至关重要。在准备过程中,充分管理抗凝剂和抗血栓药物对于预防出血很重要,预防性使用抗生素可预防伤口感染。大多数并发症较轻微;然而,可能会出现需要手术矫正或危及生命的严重并发症,如伤口感染、出血、埋藏式胃造口管综合征、结肠皮肤瘘、穿孔、肠扭转及其他器官损伤。本综述介绍了患者选择与准备、内镜插入方法及并发症处理策略的实用指南。