ESPEN-经皮内镜胃造瘘肠内营养指南英文(1).pdf

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Clinical Nutrition(2005)24, 848-861
Clinica
Nutrition
ELSEVIER
http://intl.elsevierhealth.com/journals/clnu
CONSENSUS STATEMENT
ESPEN guidelines on artificial enteral
nutrition-percutaneous endoscopic gastrostomy
(PEG
Chr. Loser ," G Aschi, X. Hebuterne, E M.H. Mathus-vliegen
M. Muscaritoli@, Y Niv, H. Rollinss, P Singer, R.H. Skelly.
amedical Department, Rotes Kreuz Krankenhaus Kassel, 34121 Kassel, Germany
Dmedical Department, AKH Wels, 4600 Wels, Austria
G/ Nutrition, Archet 2 Hospital, 06202 Nice, France
Department of Gastroenterology, Academic Medical Centre, University of Amsterdam, The Netherlands
Department of Clinical Medicine, University La Sapienza', Rome, Italy
Department of Gastroenterology, Rabin Medical Center, Tel Aviv University, israel
= Nutrition Nurse Specialist, Luton and Dunstable Hospital, Luton LU4 ODZ, UK
General Intensive Care Department, Rabin Medical Center, Petah Tiqwa 49100, /srae[
Derbyshire Royal Infirmary, Derby DE 1 2 QY, UK
Received 23 June 2005; accepted 23 June 2005
Introduction
have a broad spectrum of low risk, practicable
patient-orientated forms of enteral nutritional
Since the first published report of a percutaneous therapy available. Peg-feeding, therefore, has
endoscopic gastrostomy(PEG)in 1980 by Gauderer rapidly spread to become routine practice world
and Ponsky, 'the procedure has been modified and
ide and is currently the method of choice for
improved several times. It has now replaced the medium- and long-term enteral feeding
surgical gastrostomy (Witzel gastrostomy, Stamm
Recent studies have provided new information on
gastrostomy, Janeway gastrostomy)which was
ne benefits and drawbacks of Peg-feeding. We
associated with a markedly higher rate of compli- have a clearer appreciation of ethical issues
cations. Placement of a PEG/PE J(percutaneous surrounding artificial enteral feeding. Since we
endoscopic jejunostomy)tube is simple, safe and started placing percutaneous enteral tube systems
well-tolerated by patients. 4> There is a wide range by endoscopic techniques nearly 2.5 years ago our
of diets and nutrient preparations suitable for tube attitude towards this method has changed in many
eeding currently available. Modern PEG tube ways: in the early days Peg-tubes were often used
systems made
polyurethane or silicone rubber In patients in the advanced state of predominantly
are easy to insert and well-tolerated. Clinicians malignant diseases; this is now regarded as an
inappropriate indication in most cases being too
Corresponding author. Tel. +495613086441
late to offer adequate clinical benefits to the
fax:+49561308644.
patients in terms of nutritional status and quality of
E-mail address chr loeser@rkh-kassel de (Chr. Loser)
life. Data from a large number of recently
0261-5614/s-see front matt
doi:10.1016/j.clnu.2005.06.013
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