Ferguson D R, Harig J M, Kozarek R A, Kelsey P B, Picha G J
Cleveland Clinic Foundation, Ohio.
Am J Gastroenterol. 1993 Apr;88(4):501-4.
The procedure of choice for enteral feeding access is now percutaneous endoscopic gastrostomy (PEG). Standard PEG tubes have the disadvantages of clogging, stomal enlargement, and external bulkiness. Button replacement tubes can covert the more cumbersome PEG tubes to low external profile devices. A procedure and an early experience is described for placement of a button as a single-step procedure. This procedure is an over-the-wire, "push" procedure. Sixty-nine buttons were placed, 47 (61%) for neurologic reasons and 22 (32%) for cancer and other reasons. In 49 of the 69 (71%), there was no difficulty at all with insertion, and in only two (3%) could the button not be placed. Complications were assessed at 48 h and at 3 wk. No complications were found in 61 (90%). In only two patients (3%) were there serious complications (gastro-colon-cutaneous fistula and "peritonitis"). The One-Step Button represents a rapid, safe procedure for the placement of a low-profile PEG with its attendant advantages.
目前，肠内营养通路的首选方法是经皮内镜下胃造口术（PEG）。标准的PEG管存在堵塞、造口扩大和体外部分臃肿的缺点。纽扣式更换管可将更笨重的PEG管转变为体外轮廓较小的装置。本文描述了一种将纽扣式装置作为单一步骤放置的方法及早期经验。该方法是一种导丝引导的“推送”操作。共放置了69个纽扣式装置，其中47个（61%）是由于神经方面的原因，22个（32%）是由于癌症及其他原因。在69例中的49例（71%）中，插入过程完全没有困难，只有2例（3%）未能成功放置纽扣式装置。在术后48小时和3周时评估并发症情况。61例（90%）未发现并发症。只有2例患者（3%）出现严重并发症（胃结肠皮肤瘘和“腹膜炎”）。单步纽扣式装置代表了一种快速、安全的放置体外轮廓较小的PEG管的方法及其附带优势。
