CAJ | 학술논문

目的：探讨头颈部恶性肿瘤致吞咽困难患者行透视下经皮胃造瘘术（PFG）的护理方法。方法选择15例因头颈部恶性肿瘤导致无法进食、胃肠功能仍存在、需依赖静脉营养、行 PFG 手术患者，术前给予充分准备和心理护理，术后给予全面周到的护理，严密观察病情变化，预防各种并发症。结果15例患者均造口成功，术后1例发生胃出血，1例发生造瘘口周围感染，2例发生脱管，经处理后恢复正常。其余患者未发生并发症。15例患者术后均摆脱静脉内营养，行肠内营养支持治疗，明显提高生活质量。结论 PFG 具有操作简单、创伤小、并发症少等优点，为头颈部恶性肿瘤致吞咽困难患者提供了一个肠内营养支持治疗的新途径，良好的心理护理、术前充分准备、术后全面周到的护理和出院指导是保证PFG 成功的重要条件。
목적：탐토두경부악성종류치탄인곤난환자행투시하경피위조루술（PFG）적호리방법。방법선택15례인두경부악성종류도치무법진식、위장공능잉존재、수의뢰정맥영양、행 PFG 수술환자，술전급여충분준비화심리호리，술후급여전면주도적호리，엄밀관찰병정변화，예방각충병발증。결과15례환자균조구성공，술후1례발생위출혈，1례발생조루구주위감염，2례발생탈관，경처리후회복정상。기여환자미발생병발증。15례환자술후균파탈정맥내영양，행장내영양지지치료，명현제고생활질량。결론 PFG 구유조작간단、창상소、병발증소등우점，위두경부악성종류치탄인곤난환자제공료일개장내영양지지치료적신도경，량호적심리호리、술전충분준비、술후전면주도적호리화출원지도시보증PFG 성공적중요조건。
Objective To discuss the nursing management for patients receiving percutaneous fluoroscopy - guided gastrostomy (PFG) for the treatment of dysphagia caused by head and neck cancer. Methods A total of 15 patients with dysphagia caused by head and neck cancer received PFG. Before PFG sufficient preparation and psychological nursing care were carried out for all the 15 patients. After the operation the patients were kept under close observation for any changes in his or her clinical conditions. Proper prevention measures against complications were adopted. Results PFG procedure was successfully accomplished in all 15 patients. Postoperative complications included gastric bleeding (n = 1), stoma infection (n = 1) and proctoptosis (n = 2), and the disorders were recovered after clinical management. After PFG intravenous nutrition was no longer employed in all patients, and enteral nutrition was conducted. The quality of life was significantly improved in all patients. Conclusion PFG is technically - simple and minimally- invasive with fewer complications. This technique provides a new way to give enteral nutrition for patients with dysphagia caused by head and neck cancer. Excellent psychological nursing, sufficient preoperative preparation, comprehensive postoperative nursing care and medical advices at the time of discharge are the key points to ensure a successful PFG.