Amashubhu e-PEG: Ukusetshenziswa, Ukubekwa, Izinkinga, nokuningi

Amashubhu e-PEG: Ukusetshenziswa, Ukubekwa, Izinkinga, nokuningi

Amashubhu e-PEG: Ukusetshenziswa, Ukubekwa, Izinkinga, nokuningi

U-Isaac O. Opole, MD, PhD, ungudokotela ogunyazwe yibhodi onguchwepheshe kwezokwelapha zabadala.Usebenze iminyaka engaphezu kwe-15 e-University of Kansas Medical Center lapho futhi enguprofesa.
I-Percutaneous endoscopic gastrostomy iyinqubo lapho ithubhu yokudla eguquguqukayo (ebizwa ngokuthi i-PEG tube) ifakwe ngodonga lwesisu esiswini.Ezigulini ezingakwazi ukugwinya ukudla ngokwazo, amashubhu e-PEG avumela izakhi, uketshezi kanye nemithi ukulethwa ngokuqondile. esiswini, eqeda isidingo sokudlula emlonyeni kanye nomgudu wokugwinya.
Amashubhu okuncelisa awusizo kubantu abangakwazi ukuzondla ngenxa yokugula okuyingozi noma ukuhlinzwa kodwa abasethubeni elihle lokululama.Aphinde asize abantu abangakwazi ukugwinya okwesikhashana noma unomphela kodwa abasebenza ngendlela evamile noma abasondele kokujwayelekile.
Kulesi simo, ishubhu lokuphakelayo lingase libe ukuphela kwendlela yokunikeza ukudla okunomsoco odingeka kakhulu kanye/noma imithi.Lokhu kubizwa ngokuthi ukudla okunomsoco.
Ngaphambi kokuba wenze i-gastrostomy, umhlinzeki wakho wokunakekelwa kwezempilo uzodinga ukwazi ukuthi unazo yini izimo zempilo ezingalapheki (ezifana nomfutho wegazi ophakeme) noma izinto ezingezwani nazo emzimbeni kanye nemithi oyiphuzayo. Kungase kudingeke ukuthi uyeke imithi ethile, efana ne-blood thiners noma engeyona. izidakamizwa ezilwa nokuvuvukala (ama-NSAID), kuze kube sekupheleni kokuhlinzwa ukuze kuncishiswe ingozi yokopha.
Ngeke ukwazi ukudla noma ukuphuza amahora ayisishiyagalombili ngaphambi kokuba inqubo namalungiselelo enziwe ukuthi kube khona ozokulanda futhi akuyise ekhaya.
Uma umuntu engakwazi ukudla futhi engakwazi ukukhetha ukusebenzisa ishubhu lokuphakela, uketshezi, ama-calories, nemisoco edingekayo ukuze umuntu aphile anganikezwa ngemithambo yegazi. Ngokuvamile, ukuthola ama-calories nezakhamzimba esiswini noma emathunjini kuyindlela engcono kakhulu yokuba abantu bakuthole. imisoco edingwa yimizimba yabo ukuze isebenze kahle, ngakho-ke amashubhu okuphakelayo ahlinzeka ngemisoco engcono kunoketshezi lwe-IV.
Ngaphambi kwenqubo yokubeka i-PEG, uzothola ukulaliswa komthambo kanye nokubulala izinzwa endaweni eduze kwesayithi lokusikwa.Ungase futhi uthole ama-antibiotics emithanjeni ukuze uvimbele ukutheleleka.
Umhlinzeki wezempilo uyobe esebeka ishubhu eliguquguqukayo elikhipha ukukhanya elibizwa ngokuthi i-endoscope phansi emphinjeni wakho ukuze lisize ukuqondisa ishubhu langempela odongeni lwesisu.Kucutshungulwa okuncane ukuze kufakwe idiski ngaphakathi nangaphandle kwembobo esiswini;lokhu kuvuleka kubizwa ngokuthi i-stoma.Ingxenye yeshubhu ngaphandle komzimba ingamayintshi angu-6 kuya kwangu-12 ubude.
Ngemva kokuhlinzwa, udokotela wakho ohlinzayo uzofaka ibhandishi endaweni yokusika.Ungase uzwe izinhlungu endaweni eyisikiwe ngemva kokuhlinzwa, noma ukuminya nokuphatheka kabi ngenxa yegesi.Kungase futhi kube khona ukuvuza koketshezi endaweni eyisikiwe.Le miphumela emibi kufanele yehle. kungakapheli amahora angu-24 kuya kwangu-48. Ngokuvamile, ungakwazi ukususa ibhandishi ngemva kosuku noma ezimbili.
Ukujwayela ishubhu lokuphakelayo kuthatha isikhathi.Uma udinga ishubhu ngoba awukwazi ukugwinya, ngeke ukwazi ukudla nokuphuza ngomlomo wakho.(Ezimweni ezingavamile, abantu abanamashubhu e-PEG basengadla ngomlomo. ) Imikhiqizo eklanyelwe ukuphakelwa ngamashubhu inikeza zonke izakhamzimba ozidingayo.
Uma ungayisebenzisi, ungateyipha ishubhu esiswini sakho ngeteyiphu yezokwelapha.Isivalo noma isivalo esisekupheleni kweshubhu sivimbela noma iyiphi ifomula ukuthi ingavuzi engutsheni yakho.
Ngemva kokuba indawo ezungeze ishubhu lakho lokuphakela selipholile, uzohlangana nochwepheshe bezokudla noma isazi sokudla okunomsoco ozokubonisa ukuthi ungasebenzisa kanjani ishubhu le-PEG futhi uqale umsoco we-enteral. Nazi izinyathelo ozozilandela lapho usebenzisa amashubhu e-PEG:
Kwezinye izimo, kungase kube nzima ukunquma ukuthi ukupha umuntu ishubhu kuyinto efanele yini nokuthi iyini izimiso zokuziphatha.Izibonelo zalezi zimo zihlanganisa:
Uma wena noma othandekayo egula kakhulu futhi engakwazi ukudla ngomlomo, amashubhu e-PEG anganikeza umzimba okwesikhashana noma unomphela ukushisa nemisoco ukuze ululame futhi uchume.
Amashubhu e-PEG angasetshenziswa izinyanga noma iminyaka.Uma kunesidingo, umhlinzeki wakho wokunakekelwa kwezempilo angakwazi ukususa kalula noma ukushintsha ishubhu ngaphandle kokusebenzisa ama-sedative noma ama-anesthetics ngokusebenzisa ukudonsa okuqinile.Ngemva kokukhishwa kweshubhu, ukuvuleka kwesisu sakho kuvala ngokushesha (ngakho uma kwenzeka ngengozi, kufanele ushayele umhlinzeki wakho wezempilo ngokushesha.)
Ukuthi ukuphakelwa kwe-tube kuthuthukisa izinga lokuphila (QoL) kuncike esizeni sokudla kwepayipi kanye nesimo sesiguli.Ucwaningo lwango-2016 lwabheka iziguli eziyi-100 ezathola amashubhu okudla.Ngemva kwezinyanga ezintathu, iziguli kanye/noma abanakekeli baxoxwa.Ababhali baphetha ukuthi nakuba amashubhu engalithuthukisi izinga lempilo yeziguli, awazange ehle.
Ishubhu lizoba nophawu olubonisa lapho okufanele liguqe khona ngembobo odongeni lwesisu.Lokhu kungakusiza uqinisekise ukuthi ishubhu lisendaweni efanele.
Ungakwazi ukuhlanza ishubhu le-PEG ngokukhipha amanzi afudumele ngeshubhu ngesirinji ngaphambi nangemuva kokuncelisa noma ukuthola imithi, futhi uhlanze iziphetho ngezisuli zokubulala amagciwane.
Okokuqala, zama ukusula ishubhu njengenjwayelo ngaphambi nangemuva kokuphakelwa. Uma ishubhu lingagezwanga noma ifomula yokuphakela iwugqinsi kakhulu, kungenzeka ukuvaleka. Shayela umhlinzeki wakho wezempilo uma ishubhu lingakwazi ukususwa. Ungalokothi usebenzise izintambo nanoma yini enye ukuzama. ukuqaqa ithubhu.
Bhalisela iphephandaba lethu lansuku zonke lamathiphu ezempilo futhi uthole amathiphu nsuku zonke angakusiza uphile impilo yakho enempilo.
I-American Society of Gastrointestinal Endoscopy.Funda mayelana ne-percutaneous endoscopic gastrostomy (PEG).
U-Ojo O, u-Keaveney E, u-Wang XH, u-Feng P. Imiphumela ye-enteral tube feeding kwikhwalithi yokuphila ehlobene nempilo ezigulini: ukubuyekezwa okuhlelekile.nutrients.2019; 11 (5) .doi: 10.3390 / nu11051046
U-Metheny NA, u-Hinyard LJ, u-Mohammed KA.Isigameko se-sinusitis esihlobene noqhoqhoqho kanye namashubhu e-nasogastric: isizindalwazi se-NIS.Am J Crit Care.2018;27(1):24-31.doi:10.4037/ajcc2018978
I-Yoon EWT, Yoneda K, Nakamura S, Nishihara K. I-Percutaneous endoscopic gastrojejunostomy (PEG-J): ukuhlaziya okubuyela emuva kokusetshenziswa kwayo ekugcineni ukondleka kwesisu ngemva kokuphakelwa kwesisu okungaphumelelanga.BMJ Open Gastroenterology.2016;3(1):e0000doi98 : 10.1136/bmjgast-2016-000098
U-Kurien M, Andrews RE, Tattersall R, et al.I-Gastrostomy iyalondolozwa kodwa ayithuthukisi izinga lempilo yeziguli nabanakekeli.I-Clinical Gastroenterology and Hepatology.2017 Jul;15(7):1047-1054.doi:10.1016/j .cgh.2016.10.032


Isikhathi sokuthumela: Jun-28-2022