《中国成年患者营养治疗通路指南》解读:经皮内镜下胃/空肠造口术  

Interpretation of Guidelines for nutritional treatment pathways for adult patients in China PEG/J

作　　者：张娟娟 达彬琳 汪志明 Zhang Juanjuan;Da Binlin;Wang Zhiming(Department of General Surgery,General Hospital of Eastern Military Command of PLA,Nanjing 210009,Jiangsu,China)

机构地区：[1]中国人民解放军东部战区总医院普通外科,南京210009

出　　处：《肿瘤代谢与营养电子杂志》2022年第4期408-413,共6页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：国家自然科学基金(82070579)。

摘　　要：经皮内镜下胃/空肠造口术(PEG/J)是实现管饲喂养的一种术式,是在内镜下放置胃肠造口管的微创手术。PEG/J因操作简便易行、并发症少、耐受性佳、医疗费用低,目前国内外多项指南和共识均推荐PEG/J为长期管饲肠内营养的首选方式,其临床应用也逐步增多。为防止患者营养状况持续恶化,提高患者的生活质量,如果患者因神经系统、头颈部、消化系统等疾病存在无法进食或进食减少时,建议尽早进行PEG/J。在临床应用中,关于PEG/J的禁忌证、围手术期如何调整抗凝药物、术前是否预防性应用抗生素、术后护理等问题一直存在争议。本文就《中国成年患者营养治疗通路指南》加以解读,就PEG/J的适应证、禁忌证、围手术期处理、术式选择及并发症预防等方面提出建议,对PEG/J在临床上的应用加以指导,为中国成年患者营养治疗通路的选择提供最新的共识意见。Percutaneous endoscopic gastrostomy/jejunostomy PEG/J is a pathway of tube feeding which is a minimally invasive surgery placing PEG/J tube under an endoscope.PEG/J which is recommended by many internal and overseas guidelines and consensus has become the preferred method of enteral nutrition for long-term tube feeding due to its simple operation fewer complications good tolerability and low hospitalization costs and its clinical application is gradually increasing.In order to prevent the continuous deterioration of the nutritional status for patients and improve the quality of their life early treatment of PEG/J is recommended when the patient is unable to eat or eat less due to the disease of nervous system head and neck tumor digestive system and so on.In clinical application there are controversies about the contraindications of PEG/J how to adjust anticoagulant drugs during perioperative period whether to use prophylactic antibiotics before operation postoperative care and so on.Therefore this article interprets the Guidelines on Nutrition Therapy Pathway for Adult patients in China and proposes suggestions on the clinical indications contraindications perioperative management operational approach and prevention of complications offering guidance for the application of PEG/J in clinical practice contributing to making optimal choice in nutritional treatment pathways for adults patients according to the latest consensus.

关 键 词：经皮内镜下胃造口术 经皮内镜下空肠造口术 营养治疗通路 

分 类 号：R459.3[医药卫生—治疗学]