Sturgess R P, O'Toole P A, McPhillips J, Brown J, Lombard M G
Aintree Hospitals NHS Trust (Fazakerley), Liverpool, UK.
Eur J Gastroenterol Hepatol. 1996 Jul;8(7):631-4.
To evaluate the success rate and complications of percutaneous endoscopic gastrostomy (PEG) insertion performed with an endoscopy nurse practitioner, rather than a second doctor, carrying out percutaneous gastric puncture.
A prospective evaluation of one nurse'e performance.
The endoscopy unit in a district general hospital.
An experienced endoscopy nurse, who had undergone a specific training course in PEG insertion, participated in PEG placement in 50 unselected patients over a one year period. The outcome and complications were compared with 50 PEGs inserted over the same period by medical personnel. A standard 'pull' technique was used to insert a 15Fr tube under sedation and local anaesthetic.
The nurse was successful in PEG placement in all patients. Immediate complications from the procedure occurred in two cases in both the nurse-assisted and doctor-assisted groups. These were directly related to the gastric puncture in only one patient in each group; the others were respiratory complications related to the gastroscopy (resulting in the death of one patient). Thirty-day mortality was 8% in the nurse-assisted group and 12% following doctor-assisted PEG (mainly due to progression of the underlying condition). Outcome at 3 months was similar in the two groups, except for a slightly lower incidence of stomal infection in the nurse-assisted group.
The participation of an endoscopy nurse practitioner in the gastric puncture for PEG insertion appeared to be safe and effective and offered advantages in terms of the efficient provision of a PEG placement service, increased continuity of care for the patients and an enhanced professional role for the nurse involved.
评估由内镜护士而非第二位医生进行经皮胃穿刺的经皮内镜下胃造口术（PEG）的成功率及并发症。
对一名护士表现的前瞻性评估。
一家地区综合医院的内镜科室。
一名经验丰富且参加过PEG置入特定培训课程的内镜护士，在一年时间里参与了50例未经挑选患者的PEG置入操作。将其结果及并发症与同期由医务人员置入的50例PEG进行比较。采用标准的“牵拉”技术，在镇静和局部麻醉下置入一根15Fr的导管。
该护士对所有患者的PEG置入均获成功。护士辅助组和医生辅助组各有2例出现该操作的即刻并发症。每组中仅各有1例直接与胃穿刺相关；其他为与胃镜检查相关的呼吸并发症（导致1例患者死亡）。护士辅助组的30天死亡率为8%，医生辅助PEG置入后的死亡率为12%（主要由于基础疾病进展）。两组3个月时的结果相似，但护士辅助组的造口感染发生率略低。
内镜护士参与PEG置入的胃穿刺操作似乎安全有效，在高效提供PEG置入服务、增强患者护理的连续性以及提升参与护士的专业角色方面具有优势。
