UW MEDICINE PATIENT EDUCATION ABOUT YOUR PEG TUBE KOREAN PEG 관의설명 일반적인질문에대한대답 이유인물은경피적내시경위루술 (PEG) 관에관한일반적인질문에대한대답을제공합니다. 다른질문이나염려사항이있으면귀하의주치의에게물으십시오. PEG 관이란무엇인가? 경피적내시경위루술 (PEG) 관이란복부로부터위로들어가는부드러운플라스틱관입니다. 이관에는끝에액체음식을넣을수있는포트 ( 개구 ) 가있습니다. 정상적인식사를통해충분한영양을섭취할수없다면 PEG 관이필요할수있습니다. 영양이충분하지못하면, 체중이너무줄거나탈수 ( 신체액체의손실 ) 될수있습니다. PEG 관은신체가필요로하는영양을제공하는한방법을제공합니다. 포뮬라 ( 액체음식 ) 는관을통해공급할수있습니다. 이관은위의감압 ( 공기와액체의제거 ) 에도사용할수있습니다. PEG 관은짧은기간혹은여생동안필요할수있습니다. 더이상필요하지않을때까지배치됩니다. PEG 관의제거는쉬운시술입니다. 관이오랫동안배치된경우라도언젠가는제거해야할수있습니다. 식도 위 근육지방피부 이그림은 PEG 관의배치를보여줍니다. 이그림은 Truven Health Analytics 의허가를통해사용됨. PEG 관은어떻게배치되었는가? 위장학 ( 위, 내장및기타소화에관여하는기관들에영향을주는질환들 ) 전문의가 PEG 관을배치했습니다. 시술동안이전문의는귀하의입을통해유연한작은스코프를위안으로내려보냈습니다. 이스코프는손가락하나의두께크기이며그끝에램프와카메라가있습니다. 페이지 1 / 4 PEG 관의설명
또다른의사가특수비누로써귀하의복부피부를깨끗이닦아냈습니다. 이부위의조직안으로국소마취제 ( 마취시키는약 ) 이주입되었으며그다음작은크기의절개를시행했습니다. 이의사들은절개부위를통해위안으로 PEG 관을넣을때스코프를이용하여인도를받습니다. 플라스틱으로된플랜지 ( 디스크 ) 가이관을고정시켜줍니다. 집에돌아가는시기 이클리닉에서귀하의간호사와의추적방문은, PEG 관이배치된다음 10 에서 14 일후에있게됩니다. 이방문시, 간호사는귀하의 PEG 부위를점검하여그부위가어떻게아물고있는지확인합니다. 귀하는샤워할수있습니다. 4 주동안은목욕, 더운탕에앉아있기또는수영을하지마십시오. 면봉을이용하여플라스틱디스크 ( 플랜지 ) 아래의피부를부드럽게청소하십시오. 이부위를청결하고건조하게유지하십시오. 처음 2 주동안은부드러운일회용반창고로이부위를덮어둘수있습니다. 이부위가아문다음에는, 일회용반창고로계속덮을필요가없습니다. 아무는데약 2 주가걸릴것입니다. 평상시복용하는약을다시계속하십시오. 귀하의의사가처방하거나승인한약만드십시오. 당뇨병이있다면, 혈당을조절하는것이중요합니다. 높은혈당은 PEG 관주위의감염과피부앓이의위험을증가시킵니다. 절개부위에붉은조직 ( 육아조직 ) 의아픈과다성장이발생할수있습니다. 이것은정상적이며저희오피스에서쉽게치료가가능합니다. 이것이발생하면, 클리닉에전화하여약속을잡으십시오. 저희의사가치료해드립니다. PEG 관배치전에귀하와만난영양사가튜브영양공급이필요한경우그계획을세울것입니다. PEG 관의사용 가정주입제공자가귀하를위한포뮬라와영양공급재료를위한준비를해줍니다. 귀하와귀하의가족이 PEG 관을통해올바르게영양을공급하는방법을알도록하십시오. 귀하의일차진료제공자나가정주입제공자에게다음질문을하십시오 : - 얼마나많은양의포뮬라를얼마나자주공급해야하는가? - 한번의영양공급에걸리는시간은얼마인가? 페이지 2 / 4 PEG 관의설명
영양공급때마다포뮬라의양을늘려야할수있습니다. 귀하의몸에맞는양에도달할때까지그양을증가시킵니다. 영양사는귀하에게안맞는양의포뮬라를정하는데도움을줄수있습니다. PEG 관에알약을넣지마십시오. 액체가아닌약은액체에녹인다음에 PEG 관에넣으십시오. 액체가아닌약을녹이는방법에대해귀하의일차진료제공자에게물으십시오. PEG 관의세척 PEG 관을 60 밀리의수돗물로써하루에두번씻어내십시오. 또한약이나포뮬라의공급전후에 60 밀리의수도물로관을씻어내야합니다. 씻어내지않으면, 약과포뮬라가말라서관이막힐수있습니다. 위의감압 PEG 관을사용하지않을때에는끝에있는마개로막으십시오. 가스통증이나메스꺼움이있다면, PEG 관의마개를벗겨서위의압력을낮출수있습니다. 이로써증상을완화시킬수있습니다. PEG 관과함께생활하기 PEG 관의사용은귀하와귀하가족에게있어서생활의변화를가져올수있습니다. 귀하는 PEG 관에대해화가나거나슬프거나또는걱정하는감정을가질수있으며, 또한다른사람이어떻게생각하는지궁금할수있습니다. 이러한감정은정상적인것입니다. 귀하의진료제공자와가족또는친구와그러한감정에관해얘기하십시오. 다음요령은 PEG 관함께생활하는데도움이될수있습니다 : 영양을충분히섭취할수있도록공급스케줄을짜십시오. PEG 관이충분한수면에어려움을준다면귀하의일차진료제공자에게알리십시오. 더편안한기분이들도록집을나서기전에미리준비하십시오 : - PEG 관이새는경우를대비하여흡수가잘되는천이나패드를반드시지참하십시오. 또한갈아입을옷도준비하면좋습니다. - 공공장소에있을때혼자공급할수있는장소를미리알아두십시오. 페이지 3 / 4 PEG 관의설명
연락해야할때 7 일동안다음아발생하면, Digestive Disease Center 에즉시연락하십시오 : - 관이나관주위에출혈이있을경우. - 오한혹은화씨 100 도 ( 섭씨 37.8 도 ) 가넘는고열이있는경우. - 가슴이나배에통증이있는경우. - 구토하는경우. - 변이검을경우. - 관이막힌경우. 관으로액체를주입 ( 추가 ) 하는동안갑작스런복부통증이발생하는경우 : - 주입을즉시중단하십시오. - Digestive Disease Center 에연락하십시오. PEG 관이떨어져나간경우 : - Digestive Disease Center 에즉시연락하거나가장가까운응급실로가시폴리카테터를넣으십시오. 이렇게하지않으면몇시간이내에 PEG 관이끼워져있던입구가막힐수있습니다. 절개부위에폴리카테터를즉시끼움으로써새 PEG 관을배치할수있을때까지절개부위의열린상태유지에도움이됩니다. - 부러진 PEG 관을의사오피스나응급실로가지고오십시오. 질문이있으십니까? 귀하의질문은중요합니다. 질문이나염려사항이있으시면, 귀하의의사나진료제공자에게전화하십시오. UWMC Digestive Disease Center: 206-598-4377 Harborview Medical Center 커뮤니티케어라인 : 206-744-2500 연락처 평일오전 8 시부터오후 5 시까지는 UWMC Digestive Disease Center 에전화하십시오...206-598-4377 이시간이후와주말및휴일에는 Harborview Medical Center 에있는커뮤니티케어라인으로연락하십시오... 206-744-2500 University of Washington Medical Center About Your PEG Tube Korean Published PFES: 06/2013 Clinician Review: 06/2013 Reprints on Health Online: https://healthonline.washington.edu 페이지 4 / 4 PEG 관의설명
UW MEDICINE PATIENT EDUCATION About Your PEG Tube Answers to common questions This handout answers common questions about a percutaneous endoscopic gastrostomy (PEG) tube. Ask your primary health care provider if you have other questions or concerns. What is a PEG tube? A percutaneous endoscopic gastrostomy (PEG) tube is a soft plastic tube that goes into your stomach from your abdomen. The tube has a port (opening) on the end that you put liquid food into. You may need a PEG tube if you cannot get enough nutrition by eating normally. Without enough nutrition, you may lose too much weight or become dehydrated (lose body fluids). The PEG tube gives you a way to give your body the nutrition it needs. Formula (liquid food) can be given through the tube. The tube may also be used for decompressing your stomach (removing air and fluid). You may need a PEG tube for a short time or for the rest of your life. It will be in place until you no longer need it. Removing the PEG tube is an easy procedure. If it stays in place for a long time, it may need to be replaced at some point. This drawing shows the placement of the PEG tube. Drawing used with permission from Truven Health Analytics. How was your PEG tube placed? A doctor who specializes in gastroenterology (disorders that affect the stomach, intestines, and other organs involved in digestion) placed your PEG tube. During the procedure, this doctor placed a small flexible scope through your mouth and down into your stomach. This scope is about the width of a finger and has a light and camera on its tip. Page 1 of 4 About Your PEG Tube
Another doctor cleaned the skin on your abdomen with special soap. A local anesthetic (numbing medicine) was injected into your tissue in this area, and then a small incision was made. The doctors used the scope to guide them as they pulled the PEG tube into your stomach through the incision. A plastic flange (disk) holds the tube in place. When You Get Home Your follow-up visit with a nurse in our clinic is scheduled for 10 to 14 days after your PEG tube is placed. At this visit, the nurse will check your PEG site to see how the area is healing. You may shower. Do not take a bath, sit in a hot tub, or go swimming for 4 weeks. Use a Q-tip to gently clean the skin under the plastic disk (flange). Keep the area clean and dry. You can cover it with a soft bandage for the first 2 weeks. After the area has healed, you do not need to keep it covered with a bandage. It will take about 2 weeks to heal. Resume taking your usual medicines. Take only the medicines that your doctors prescribed or approved. If you have diabetes, it is important to manage your blood sugar levels. High blood sugar levels increase your risk for infection and skin sores around your PEG tube. A tender overgrowth of red tissue (granulation tissue) can occur at the incision site. This is normal and can easily be treated in our office. If it occurs, call our clinic to make an appointment. One of our doctors will look at it. The dietitian who met with you before your PEG tube was placed will set up a plan for you to get tube feedings when and if you need them. Using Your PEG Tube A home infusion provider will arrange for your formula and feeding supplies. Make sure you or a family member knows how to correctly give feedings through your PEG tube. Ask your primary care provider or home infusion provider: How much formula should you get, and how often? How much time should each feeding take? Page 2 of 4 About Your PEG Tube
You may need to increase the amount of formula you get with each feeding. You will increase the amount until you reach the right amount for your body. A dietitian may help you figure out the right amount of formula to give yourself. Do NOT put pills into your PEG tube. Dissolve non-liquid medicines in liquid before you put them in your PEG tube. Ask your primary care provider to show you how to dissolve non-liquid medicines. Flushing Your PEG Tube Flush your PEG tube 2 times a day with 60 ml of tap water. You will also need to flush your tube with 60 ml of tap water before and after each time you give yourself any medicines or formula. If you do not flush it, medicines and formula can dry up and clog the tube. Decompressing Your Stomach Close the cap on the end of your PEG tube when you are not using it. If you have gas pains or nausea, you can decompress your stomach by taking the cap off the PEG tube. This can ease your symptoms. Living with a PEG Tube Having a PEG tube may be life-changing for you and your family. You may feel angry, sad, or worried about the PEG tube, and you might wonder what others think of it. These feelings are normal. Talk with your health care providers, family, or friends about your feelings. These tips may help make living with a PEG tube easier: Arrange your feeding schedule in a way that allows you to get enough sleep. Tell your primary care provider if the PEG tube makes it hard for you to sleep. Prepare ahead of time before you leave your home so that you feel more comfortable: Make sure you have absorbent cloths or pads with you in case your PEG tube leaks. You may also want to bring a change of clothing. Find out in advance where you can feed privately when you are in public places. Page 3 of 4 About Your PEG Tube
When to Call In the next 7 days, call the Digestive Disease Center right away if: There is bleeding from the tube or around the tube. You have chills or a fever higher than 100 F (37.8 C). You have pain in your chest or belly. You are vomiting. Your stool is black. The tube is clogged. If you get sudden belly pain while you are infusing (adding) fluids to your tube: Stop the infusion right away. Call the Digestive Disease Center. If your PEG tube falls out: Call the Digestive Disease Center right away or go to the nearest emergency room to have a Foley catheter put in. The PEG tube opening might close up within hours if you do not do this. Having a Foley catheter put in your incision site right away will help keep your incision open until a new PEG tube can be placed. Bring the broken PEG tube with you to your doctor s office or the emergency room. Questions? Who to Call Weekdays between 8 a.m. and 5 p.m., call the UWMC Digestive Disease Center... 206-598-4377 After hours and on weekends and holidays, call the Community Care Line at Harborview Medical Center... 206-744-2500 Your questions are important. Call your doctor or health care provider if you have questions or concerns. UWMC Digestive Disease Center: 206-598-4377 Community Care Line at Harborview Medical Center: 206-744-2500 University of Washington Medical Center Published PFES: 06/2013 Clinician Review: 06/2013 Reprints on Health Online: https://healthonline.washington.edu Page 4 of 4 About Your PEG Tube