實施經皮內視鏡胃造瘻術病童之照護

Nursing Care for Children Undergoing Percutaneous Endoscopic Gastrostomy

經皮內視鏡胃造術自1980年Gauderer、Ponsky及Izant等人首度引用至今，已被廣泛應用於各種無法由口進食的病人身上。對於長期需要管灌餵食的病童而言，是一種安全且有效的營養提供方式。不但手術方法簡單，僅需局部麻醉、省時、操作方便，而且也讓病童免除因插鼻胃管所造成的鼻腔或食道糜爛、經常滑脫而必須重插胃管、吸入性肺炎等合併症。因此，以胃造管取代鼻胃管是長期管灌餵食病童之另ㄧ選擇。本文彙整經皮內視鏡胃造術相關文獻，針對其適應症、合併症、何時需要更換胃造管及護理等加以闡述，期望能提供臨床護理人員照護病童之參考。

Ever since percutaneous endoscopic gastronomy (PEG) was used for the first time in 1980 by Gauderer, Ponsky, Izant et al., It has been widely used in patients incapable of oral feeding. It is a safe and effective technique for long-term nutritional support in children, and easy to perform, as only local anesthesia or heavy sedation is required. PEG can prevent children from suffering from nasopharyngeal and esophageal erosions due to repeated insertion of nasogastric tubes and the complication of aspiration pneumonia. It is therefore an alternative for children who need long-term feeding. In this article we review the literature on PEG and give a full description of its indications, complications, as well as advice on when to change gastrostomy tubes, and on nursing care, in the hope that this will be useful reference material for medical staff.