I-PEG Tubes: Ukusetyenziswa, ukubekwa, iingxaki, kunye nokunye

I-PEG Tubes: Ukusetyenziswa, ukubekwa, iingxaki, kunye nokunye

I-PEG Tubes: Ukusetyenziswa, ukubekwa, iingxaki, kunye nokunye

U-Isaac O. Opole, MD, PhD, ngugqirha oqinisekisiweyo webhodi oyingcali kwiyeza ze-geriatric.Usebenze iminyaka engaphezu kwe-15 kwiYunivesithi yaseKansas Medical Centre apho naye unguprofesa.
I-Percutaneous endoscopic gastrostomy yinkqubo apho ityhubhu yokutya eguquguqukayo (ebizwa ngokuba yi-PEG tube) ifakwe ngodonga lwesisu esiswini.Izigulane ezingakwazi ukuginya ukutya ngokwazo, iibhubhu ze-PEG zivumela izondlo, ulwelo kunye namayeza ukuba ahanjiswe ngokuthe ngqo. esiswini, ukuphelisa isidingo sokudlula emlonyeni kunye nomqala wokuginya.
Iityhubhu zokutya ziluncedo kubantu abangakwaziyo ukuzondla ngenxa yesifo esibuhlungu okanye utyando kodwa banethuba elifanelekileyo lokubuyisela.Bakwanceda abantu abangenakugwinya okwethutyana okanye ngokusisigxina kodwa basebenze ngokuqhelekileyo okanye basondele kwisiqhelo.
Kule meko, ityhubhu yokutya ingaba yindlela yodwa yokubonelela ngesondlo esifunekayo kunye / okanye amayeza.Oku kubizwa ngokuba yi-enteral nutrition.
Ngaphambi kokuba ube ne-gastrostomy, umboneleli wakho wezempilo uya kufuna ukwazi ukuba unayo naziphi na iimeko zempilo ezingapheliyo (ezifana noxinzelelo lwegazi oluphezulu) okanye i-allergies kunye namayeza owathathayo.Unokufuna ukuyeka amayeza athile, afana ne-blood thinners okanye non- iziyobisi ezichasene nokudumba (i-NSAIDs), kude kube sekupheleni kotyando ukunciphisa umngcipheko wokopha.
Awuyi kukwazi ukutya okanye ukusela iiyure ezisibhozo phambi kokuba inkqubo kunye namalungiselelo enziwe ukuba kubekho umntu oza kukulanda akugoduse.
Ukuba umntu akakwazi ukutya kwaye akanakukhetha ityhubhu yokutyisa, ulwelo, iikhalori, kunye nezondlo ezifunekayo ukuze umntu aphile zinokubonelelwa ngemithambo yegazi. Ngokufuthi, ukufumana ii<em>calories nezondlo esiswini okanye emathunjini yeyona ndlela ilungileyo yokuba abantu bafumane. izondlo ezidingwa yimizimba yazo ukuze zisebenze ngokugqibeleleyo, ngoko ke iityhubhu zokutyisa zibonelela ngezondlo ezingcono kune-IV fluids.
Ngaphambi kwenkqubo yokubeka i-PEG, uya kufumana i-intravenous sedation kunye ne-anesthesia yendawo ejikeleze indawo yokusika.Unokufumana kwakhona i-antibiotics emithanjeni ukukhusela usulelo.
Umboneleli wezempilo uya kuthi emva koko abeke ityhubhu eguquguqukayo ekhupha ukukhanya ebizwa ngokuba yi-endoscope emqaleni wakho ukuze uncede ukukhokela ityhubhu yangempela ngodonga lwesisu.I-incision encinci yenziwe ukubeka i-disc ngaphakathi nangaphandle kokuvula kwisisu;oku kuvuleka kubizwa ngokuba yi-stoma.Inxalenye yombhobho ongaphandle komzimba yi-intshi ezi-6 ukuya kwezi-12 ubude.
Emva kotyando, ugqirha wakho wotyando uya kufaka ibhandeji kwindawo yokusikeka.Unokuba neentlungu ezijikeleze indawo yokusikwa emva kotyando, okanye ukunyanzeliswa nokungakhululeki kwigesi.Kusenokubakho ukuvuza kwamanzi okujikeleze indawo yokusika. Ezi ziphumo bezingalindelekanga kufuneka zithobe. ngaphakathi kwe-24 kwiiyure ze-48. Ngokuqhelekileyo, unokususa i-bandage emva kosuku okanye ezimbini.
Ukuqhela ityhubhu yokuxheshisela kuthatha ixesha. Ukuba ufuna ityhubhu kuba awukwazi ukuginya, awuzukwazi ukutya nokusela ngomlomo wakho. ) Iimveliso ezenzelwe ukutya ityhubhu zibonelela ngazo zonke izondlo ozifunayo.
Xa ungayisebenzisi, unokuteyipha ityhubhu esiswini sakho nge tape yonyango.Isithinteli okanye ikepusi ekupheleni kombhobho ithintela nayiphi na ifomula ukuba ingavuzi kwimpahla yakho.
Emva kokuba indawo ejikeleze ityhubhu yakho yokutyisa ipholile, uya kudibana nengcali yokutya okanye ingcali yokutya eya kukubonisa indlela yokusebenzisa ityhubhu ye-PEG kwaye uqalise i-enteral nutrition.Nanga amanyathelo oya kuwalandela xa usebenzisa i-PEG tubes:
Kwezinye iimeko, kunokuba nzima ukufumanisa ukuba ukondla umntu ityhubhu yinto efanelekileyo yokwenza kwaye yintoni ingcamango yokuziphatha.Imizekelo yezi meko iquka:
Ukuba wena okanye othandekayo ugula kakhulu kwaye awukwazi ukutya ngomlomo, iityhubhu ze-PEG zinokunika umzimba ubushushu kunye nezondlo okwethutyana okanye ngokusisigxina ukuze uphile kwaye uphumelele.
Iibhubhu ze-PEG zingasetyenziselwa iinyanga okanye iminyaka.Ukuba kuyimfuneko, umboneleli wakho wezempilo unokususa ngokulula okanye atshintshe ityhubhu ngaphandle kokusetyenziswa kwe-sedative okanye i-anesthetics ngokusebenzisa i-traction eqinile.Emva kokuba ityhubhu isusiwe, ukuvuleka kwesisu sakho kuvala ngokukhawuleza (ngoko ukuba ivele ngengozi, kufuneka ufowunele umboneleli wakho wezempilo ngoko nangoko.)
Ingaba ukutya ityhubhu kuphucula umgangatho wobomi (QoL) kuxhomekeke kwisizathu sokutya ityhubhu kunye nemeko yesigulane.Uphononongo lwe-2016 lujonge izigulane ze-100 ezifumene iibhubhu zokutya.Emva kweenyanga ezintathu, izigulane kunye / okanye abanakekeli baxoxwa. ukuba ngelixa iityhubhu zingakhange ziphucule umgangatho wobomi bezigulane, azizange zehle.
Ityhubhu iya kuba nophawu olubonisa apho kufuneka igungxulwe khona ngokuvula kudonga lwesisu.Oku kunokukunceda uqinisekise ukuba ityhubhu ikwimeko echanekileyo.
Unokuyicoca ityhubhu ye-PEG ngokugungxula amanzi afudumeleyo ngombhobho ngesirinji ngaphambi nangemva kokutyisa okanye ukufumana iyeza, kunye nokucoca iziphelo ngezisusi zokubulala iintsholongwane.
Okokuqala, zama ukugungxula ityhubhu njengesiqhelo ngaphambi nasemva kokutya.Ukuba ityhubhu ayigungxulwanga okanye ifomula yokutyisa inzima kakhulu, ukuvala kuyenzeka.Biza umboneleli wakho wezempilo ukuba ityhubhu ayinakususwa.Ungasebenzisi iingcingo okanye nantoni na ukuzama ukukhulula ityhubhu.
Bhalisela incwadana yeendaba yezempilo yemihla ngemihla kwaye ufumane iingcebiso zemihla ngemihla ukukunceda uphile ubomi bakho obusempilweni.
I-American Society of Gastrointestinal Endoscopy.Funda malunga ne-percutaneous endoscopic gastrostomy (PEG).
U-Ojo O, uKeaveney E, uWang XH, uFeng P. Iimpembelelo ze-enteral tube feed kumgangatho wobomi obunxulumene nempilo kwizigulane: ukuhlaziywa okucwangcisiweyo.nutrients.2019; 11 (5) .doi: 10.3390 / nu11051046
U-Metheny NA, u-Hinyard LJ, u-Mohammed KA. Iziganeko ze-sinusitis ezinxulumene ne-trachea kunye ne-nasogastric tubes: i-NIS database.Am J Crit Care.2018; 27 (1): 24-31.doi: 10.4037 / ajcc2018978
I-Yoon EWT, i-Yoneda K, i-Nakamura S, i-Nishihara K. I-Percutaneous endoscopic gastrojejunostomy (PEG-J): uhlalutyo lwangaphambili lwe-utility yayo ekugcineni isondlo somzimba emva kokungaphumeleli kokutya kwesisu.BMJ Open Gastroenterology.2016;3 (1):e0000doi89: : 10.1136/bmjgast-2016-000098
Kurien M, Andrews RE, Tattersall R, et al.Gastrostomy igcinwe kodwa ayiphuculi umgangatho wobomi bezigulane kunye nabanyamekeli.I-Clinical Gastroenterology and Hepatology.2017 Jul; 15 (7): 1047-1054.doi: 10.1016 / j .cgh.2016.10.032


Ixesha lokuposa: Jun-28-2022