PEG Tubes: Mashandisirwo, Kuiswa, Matambudziko, uye Zvimwe

PEG Tubes: Mashandisirwo, Kuiswa, Matambudziko, uye Zvimwe

PEG Tubes: Mashandisirwo, Kuiswa, Matambudziko, uye Zvimwe

Isaac O. Opole, MD, PhD, ibhodhi-yakasimbiswa chiremba nyanzvi mune geriatric medicine.Akashanda kwemakore anopfuura 15 paYunivhesiti yeKansas Medical Center uko ariwo purofesa.
Percutaneous endoscopic gastrostomy inzira iyo flexible feeding tube (inonzi PEG tube) inopinzwa kuburikidza nemadziro emimba mudumbu.Kune varwere vasingakwanisi kumedza zvokudya ivo pachavo, PEG tubes inobvumira kudya, mvura uye mishonga kuti iendeswe zvakananga. mudumbu, zvichibvisa kudiwa kwekunzvenga muromo negurokuro pakumedza.
Machubhu ekudyisa anobatsira vanhu vasingakwanisi kuzvidyisa nekuda kwehurwere hwakanyanya kana kuvhiyiwa asi vane mukana wakanaka wekupora.Anobatsirawo vanhu vanenge vasingakwanisi kumedza kwekanguva kana kuti zvachose asi vari kushanda zvakanaka kana kuti vari pedyo.
Muchiitiko ichi, chubhu yekudyisa inogona kunge iri nzira chete yekupa chikafu chinodiwa uye / kana mishonga.Izvi zvinonzi enteral nutrition.
Usati waita gastrostomy, mutarisiri wako wehutano achada kuziva kana uine chero mamiriro ehutano asingaperi (akadai seBP) kana allergies nemishonga yaunotora.Ungangoda kumisa mimwe mishonga, yakadai seropa rinotetepa kana risiri- steroidal anti-inflammatory drugs (NSAIDs), kusvika pakupera kwekuvhiyiwa kuderedza njodzi yekubuda ropa.
Iwe hauzokwanisi kudya kana kunwa kwemaawa masere maitiro uye hurongwa husati hwaitwa hwekuti mumwe munhu akutakure nekukuendesa kumba.
Kana munhu asingakwanisi kudya uye asina sarudzo yechubhu yekudyisa, zvinwiwa, macalorie, uye zvinovaka muviri zvinodiwa kuti urarame zvinogona kupihwa netsinga.Kazhinji, kuwana macalorie nezvinovaka muviri mudumbu kana muura ndiyo nzira yakanakisa yekuti vanhu vawane. chikafu chinodiwa nemiviri yavo kuti chishande zvakanaka, saka machubhu ekudyisa anopa kudya kuri nani pane zvinwiwa zveIV.
Pamberi pePGG yekuisa nzira, iwe uchagamuchira intravenous sedation uye anesthesia yemunharaunda yakapoteredza nzvimbo yekucheka.Unogonawo kugamuchira mishonga inorwisa mabhakitiriya kudzivirira utachiona.
Mutariri wehutano achazoisa chubhu ine chiedza-emitting flexible chubhu inonzi endoscope pasi pehuro yako kuti ibatsire kutungamirira chubhu chaiyo kuburikidza nemadziro emudumbu.Kucheka kuduku kunogadzirwa kuisa disc mukati nekunze kwekuvhura mudumbu;kuvhura uku kunonzi stoma.Chikamu chechubhu chiri kunze kwemuviri chakareba masendimita matanhatu kusvika gumi nemaviri.
Mushure mekuvhiyiwa, chiremba wako anovhiya achaisa bhandeji panzvimbo yekucheka.Unganzwa mamwe marwadzo akapoteredza nzvimbo yekucheka mushure mekuvhiyiwa, kana kuputika uye kusagadzikana kubva kune gasi.Panogonawo kuva nekubuda kwemvura kunopoteredza nzvimbo yekucheka.Izvi zvinokanganisa zvinofanira kupera. mukati me24 kusvika maawa 48. Kazhinji, unogona kubvisa bhanhire mushure mezuva kana maviri.
Kujairira chubhu yekudyisa kunotora nguva. Kana uchida chubhu nekuti haugone kumedza, hauzokwanisi kudya nekunwa nemuromo wako.(Kashoma, vanhu vane machubhu ePEG vanogona kudya nemuromo. ) Zvigadzirwa zvakagadzirirwa kudyisa chubhu zvinopa zvese zvinovaka muviri zvaunoda.
Paunenge usiri kuishandisa, unogona kutepa chubhu kudumbu rako netepi yekurapa.Chivharo kana chivharo chiri kumucheto kwechubhu chinodzivirira chero fomula kuti risaderere pachipfeko chako.
Mushure mekunge nzvimbo yakapoteredza chubhu yako yekudyisa yapora, uchasangana nenyanzvi yezvekudya kana nyanzvi yezvekudya uyo anokuratidza mashandisiro echubhu yePEG uye kutanga kudya kunovaka muviri. Heano matanho auchatevera kana uchishandisa PEG chubhu:
Mune zvimwe zviitiko, zvinogona kunetsa kuona kana kudyisa munhu chubhu chiri chinhu chakakodzera kuita uye kuti zvinotariswa netsika ndezvipi.Mienzaniso yemamiriro aya inosanganisira:
Kana iwe kana mudiwa achirwara zvakanyanya uye asingakwanisi kudya nemuromo, machubhu ePEG anogona kupa muviri kupisa uye zvinovaka muviri kwechinguvana kana kuti zvachose kuti upore uye ubudirire.
PEG machubhu anogona kushandiswa kwemwedzi kana makore.Kana zvichidikanwa, mutarisiri wako wehutano anogona kubvisa nyore nyore kana kutsiva chubhu pasina kushandisa sedative kana anesthetics nekushandisa traction yakasimba.Mushure mekunge chubhu yabviswa, kuvhura mudumbu rako kunovhara nekukurumidza (saka kana zvikaitika netsaona, unofanira kufonera mutarisiri wako wehutano ipapo ipapo.)
Kana kudyisa kwechubhu kunovandudza mararamiro ehupenyu (QoL) kunoenderana nechikonzero chekudya kwechubhu uye mamiriro emurwere.Chidzidzo che 2016 chakatarisa varwere ve100 vakagamuchira machubhu ekudya.Pashure pemwedzi mitatu, varwere uye / kana vatarisi vakabvunzurudzwa.Vanyori vakapedzisa kuti nepo machubhu asina kuvandudza mararamiro evarwere, haana kuderera.
Iyo chubhu inenge iine mucherechedzo unoratidza painofanira kugezeswa nepakazaruka pamadziro edumbu.Izvi zvinogona kukubatsira kuti usimbise kuti chubhu iri panzvimbo chaiyo.
Unogona kuchenesa chubhu yePEG nekukwesha mvura inodziya nemuchubhu nejekiseni usati wadya kana kupihwa mushonga, uye nekuchenesa migumo nemishonga yekuuraya utachiona.
Chekutanga, edza kugezesa chubhu semazuva ese usati wapedza uye wapedza kudyisa. Kana chubhu isina kugezeswa kana kuti fomula yekudyisa yanyanya kukora, kuvhara kunogona kuitika. Fonera mutarisiri wako wehutano kana chubhu isingakwanisi kubviswa. Usamboshandisa waya kana chimwe chinhu kuedza. kusunungura chubhu.
Nyorera kune yedu yemazuva ese ehutano mazano enhau uye ugamuchire matipi emazuva ese ekukubatsira iwe kurarama hupenyu hune hutano.
American Society of Gastrointestinal Endoscopy.Dzidza nezve percutaneous endoscopic gastrostomy (PEG).
Ojo O, Keaveney E, Wang XH, Feng P. Migumisiro ye enteral tube kudya pahutano hwehutano hwehupenyu muvarwere: kuongorora kwakarongeka.nutrients.2019; 11 (5) .doi: 10.3390 / nu11051046
Metheny NA, Hinyard LJ, Mohammed KA.Chiitiko che sinusitis chakabatana ne trachea uye nasogastric tubes: database yeNIS.Am J Crit Care.2018;27(1):24-31.doi:10.4037/ajcc2018978
Yoon EWT, Yoneda K, Nakamura S, Nishihara K. Percutaneous endoscopic gastrojejunostomy (PEG-J): kuongorora kwakadzokororwa kwekushandisa kwayo mukuchengetedza kudya kwemukati mushure mekusabudirira kwekudya kwegastric.BMJ Open Gastroenterology.2016;3(1):e0000doi89:e0000. : 10.1136/bmjgast-2016-000098
Kurien M, Andrews RE, Tattersall R, et al.Gastrostomy inochengetedzwa asi haina kuvandudza mararamiro evarwere nevatarisiri.Clinical Gastroenterology and Hepatology.2017 Jul;15(7):1047-1054.doi:10.1016/j .cgh.2016.10.032


Nguva yekutumira: Jun-28-2022