| 特集名 | PEGの現状 | |
|---|---|---|
| 題名 | PEGの管理 (4) PEGの管理と晩期合併症 | |
| 発刊年月 | 2013年 09月 | |
| 著者 | 西山 順博 | 西山医院 |
| 著者 | 伊藤 明彦 | 誠光会草津総合病院 |
| 著者 | 山田 圭子 | 誠光会草津総合病院 |
| 【 要旨 】 | PEG（経皮内視鏡的胃瘻造設術）管理における晩期合併症には，頻度は多くないが重篤な合併症と，頻度が多く重篤にはならないが在宅や施設での管理を悩ます合併症がある．重篤な合併症は，(1) カテーテル事故（自己）抜去，(2) バンパー埋没症候群，(3) 胃潰瘍，(4) カテーテル交換時の誤挿入があり，緊急連絡網の整備が何よりも重要である．頻度の多い合併症には，(1) 瘻孔周囲のスキントラブル，(2) 瘻孔周囲の漏れ（栄養材のリーク），(3) カテーテルの閉塞，(4) 嘔吐，(5) 便秘・下痢，(6) 誤嚥性肺炎があげられ，慢性化することも多く適切な対応が必要となる．晩期合併症で胃瘻患者のQOLを損ねないように，施設格差がないように，地域連携パスを啓発するなかで，いくつかのアイテムを活用し対応している． | |
| Theme | The Present State of Percutaneous Endoscopic Gastrostomy (PEG) | |
|---|---|---|
| Title | Management of Percutaneous Endoscopic Gastrostomy (PEG) and Late Complications | |
| Author | Yorihiro Nishiyama | Nishiyama Clinic |
| Author | Akihiko Itou | Kusatsu General Hospital, Shiga Japan |
| Author | Keiko Yamada | Kusatsu General Hospital, Shiga Japan |
| [ Summary ] | Late complications are those which are not common but serious, and others which are not serious but very common and can cause trouble with management of in home or institutional care. Serious complications are as follows : 1) accidental removal of catheters (self catheter removal), 2) buried bumper syndrome, 3) gastric ulcers, and 4) misplacement of catheters. These types of complications, require an emergency contact network. Common complications include the following : 1) complications with skin around the fistula, 2) leakage around the fistula, 3) occlusion of the catheter, 4) vomiting, 5) constipation/diarrhea, and 6)aspirational pneumonia. These conditions require appropriate treatment as they often become chronic. In order to avoid late complications causing decreased quality of life in PEG patients, and to avoid discrepancies between care institutions, we handle these problems by making use of several kinds of equipment, while enlightening others concerning regional cooperation. |
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