Percutaneous Endoscopic Gastrostomy (PEG) Feeding Tube 

經(jīng)皮內(nèi)鏡下胃造口（PEG）喂養(yǎng)管

Your doctor may perform a percutaneous endoscopic gastrostomy or PEG, to insert a feeding tube into your stomach if you were unable to take food by mouth for an extended period of time. Digestion of food begins in the mouth. When you swallow, food is pushed down into your esophagus, a muscular tube that carries food to your stomach where it is digested. From the stomach, food travels to your small intestine, where digestion continues and nutrients are absorbed into the bloodstream. 

如果患者在相當(dāng)長的時(shí)間內(nèi)無法經(jīng)口攝入食物，醫(yī)生可能行經(jīng)皮內(nèi)鏡下胃造口術(shù)（PEG），向患者胃內(nèi)插入喂養(yǎng)管。食物消化始于口腔?；颊咄萄蕰r(shí)，食物被推入食管，食管是一種肌肉管，負(fù)責(zé)將食物運(yùn)送至胃進(jìn)行消化。食物自胃進(jìn)入小腸，繼續(xù)消化，營養(yǎng)物質(zhì)被吸收入血液。

Your doctor may require a PEG feeding tube if you cannot eat, digest or absorb food due to esophageal cancer, oral surgery or stroke, major surgery, trauma, burns or anorexia, inflammation of the pancreas, or radiation therapy, or inflammatory bowel disease affecting the small intestine.

患者因食管癌，口腔手術(shù)或休克、大型手術(shù)，創(chuàng)傷，燒傷或厭食癥、胰腺炎、或者放療，或累及小腸的炎性腸病而不能進(jìn)食，消化或吸收食物時(shí)，醫(yī)生可能要求插入PEG喂養(yǎng)管。

Before the procedure, you'll receive a sedative through an IV to help you relax. A local anesthetic will be administered at the site on your abdomen where the PEG tube is to be placed. The most commonly used PEG placement procedure is the Pull Method. 

術(shù)前，患者將接受IV鎮(zhèn)靜劑，以快速進(jìn)入鎮(zhèn)靜狀態(tài)。醫(yī)生將在患者腹部PEG管置入部位局部注射麻醉劑。最常用的PEG置入術(shù)是拖出法（Pull Method）。

During this procedure, your doctor will insert a lighted endoscope through your mouth and thread it down your esophagus and into your stomach. A camera attached to the endoscope will produce images of the inside of your stomach, which will be displayed on a video monitor. Next, your doctor will insert a needle through your skin into your stomach at the location where the PEG tube is to be placed. 

術(shù)中，醫(yī)生將經(jīng)由患者口腔插入發(fā)光內(nèi)窺鏡，并將其穿過食管，插入胃內(nèi)。與內(nèi)窺鏡連接的相機(jī)將生成胃內(nèi)圖像，該圖像將顯示在視頻監(jiān)視器上。接下來，醫(yī)生會(huì)經(jīng)皮將一根針插入患者胃部PEG置入部位。

While doing this, he or she will use the endoscope to locate the end of the needle inside your stomach and encircle it with a wire snare. Your doctor will then pass a thin wire through this needle into your stomach, attach the endoscope to the wire, and pull both the endoscope and wire out through your mouth. At this point, there will be a thin wire entering the front of your abdomen into your stomach and continuing upward and out of your mouth. Your doctor will attach the PEG feeding tube to the wire outside of your mouth. By gently tugging on the other end of the wire, he or she will pull the tube back through your mouth and esophagus and into your stomach. 

在此期間，他/她將應(yīng)用內(nèi)窺鏡將針末端固定在胃內(nèi)，并使用金屬絲圈套環(huán)繞。然后，通過針將一根細(xì)線穿入胃，連接內(nèi)窺鏡和線，然后經(jīng)由口腔將其拖出。此時(shí)，進(jìn)入腹部前方的線將進(jìn)入胃，并繼續(xù)向上，從口腔拖出。醫(yī)生會(huì)將PEG喂養(yǎng)管與口腔外的線連接，輕輕拉扯線另一端，將管經(jīng)由口腔和食管拖回胃內(nèi)。

Your doctor will continue to pull until the tip of the tube comes out of the incisions in your stomach and abdomen. A soft round bumper attached to the portion of the tube that remains inside the stomach secures it in place. The outer portion of the tube will be secured with a bumper as well, and sterile gauze will be placed around the incision site. In the alternative push method, your doctor will begin in the same fashion by using an endoscope to guide a wire through your abdominal wall and into your stomach. But instead of pulling the PEG tube through your mouth, he or she will push it directly into your stomach over the wire. 

醫(yī)生將繼續(xù)拖拉，直至管尖端自患者胃和腹部切口被拖出。胃內(nèi)連接管的柔軟圓形緩沖器將其固定到位。外部管也由緩沖器固定，切口周圍放置消毒紗布。應(yīng)用替代推入法時(shí)，醫(yī)生將以相同的方式，應(yīng)用內(nèi)窺鏡引導(dǎo)線通過腹壁，進(jìn)入胃。但是他/她不會(huì)將PEG管經(jīng)由口腔拖出，而是通過線將其直接推入胃內(nèi)。

After your procedure, you will continue to receive fluids through an IV for one to two days. Once there is evidence that your digestive tract is functioning, you will receive clear liquids through the PEG tube. If clear liquids are tolerated, you will receive a tube feeding formula through the PEG tube.

術(shù)后，患者繼續(xù)接受靜脈輸液1~2天。一旦有跡象表明消化功能趨于正常，患者將接受PEG管流質(zhì)喂養(yǎng)；如果可以接受流質(zhì)，將接受PEG管管飼喂養(yǎng)。