تركيب أنبوب فغر المعدة وأنبوب فغر الصائم وأنبوب الفغر المعدي الصائمي

ما هو فغر المعدة؟

فغر المعدة هو نوع من الجراحة لعمل فتحة صغيرة عبر الجلد إلى المعدة لأنبوب تغذية. تسمى الفتحة الفغرة. إجراء عمل الفتحة يُسمى الفغر. تشمل الأنواع الأخرى من إجراءات الفغر لأنابيب التغذية الفغر المعدي الصائمي وفغر الصائم..

يضع الطبيب أنبوب التغذية في الفغرة. ويُسمى أنبوب فغر المعدة أو أنبوب الفغر المعدي الصائمي أو أنبوب فغر الصائم بناءً على مكان وضعه. اعثر على معلومات حول أنواع أنابيب التغذية.

لدى بعض الأطفال جهاز بلاستيكي صغير يُسمى زرًا بدلاً من أنبوب. يحصل طفلكم على الطعام والأدوية من خلال الأنبوب أو الزر.

بعد أن يضع الطبيب الأنبوب في مكانه، يتم ملء بالون صغير في النهاية بالماء. وهذا يمنع الأنبوب من الخروج. وتساعد أداة تثبيت خارجية أو قرص خارجي على تثبيته في مكانه على الجلد من الخارج.

قد يتم إجراء فغر أنبوب التغذية بثلاث طرق رئيسية:

1. التصور الموجّه
2. الجراحة (مفتوحة أو بالمنظار)
3. التنظير الداخلي (فغر المعدة)

يمكن أن يعتمد نوع الإجراء الذي يخضع له طفلكم على عدة عوامل. قد تشمل هذه العوامل صحة طفلكم والجراحات أو الإجراءات المخطط لها والموارد المتاحة في المستشفى.

بناءً على الإجراء، قد يُطلب منكم عدم تناول طفلكم أي طعام أو شراب عن طريق الفم لفترة زمنية محددة قبل الإجراء. من المهم جدًا اتباع هذه التعليمات الخاصة بعدم تناول شيء بالفم.

بعد الإجراء، من المحتمل أن يبقى طفلكم في المستشفى طوال الليل للمراقبة والسيطرة على الألم. اتبعوا تعليمات فريق الرعاية المتابع لكم بشأن التغذية بالأنبوب وإعطاء الأدوية من خلال أنبوب تغذية. ستبدأ السوائل أو التغذية المعدية ببطء للتأكد من أن أنبوب التغذية يعمل بشكل صحيح ولمساعدة الجهاز الهضمي في التكيف.

What to expect before the feeding tube placement

Before the procedure, your care team will go over what to expect and explain: 

• Why nutrition support is important and what type of feeding tube is best for your child’s needs 
• What to expect during the procedure 
• Possible risks and what problems to watch for 

Fasting guidelines 

Your child will have anesthesia for the feeding tube placement. Your child should not eat or drink anything by mouth, including candy and gum, for several hours before the procedure. This is called fasting. Your care team will tell you when your child should start fasting. You might also hear fasting called NPO. This is short for a Latin phrase that means “nothing by mouth." It is important to follow all fasting instructions from your care team.  

What to expect during feeding tube placement

There are 3 main ways to place a feeding tube: 

• Image-guided (Interventional Radiology): X-rays and other imaging tests are used to help put the feeding tube in the right place. This is done in a special interventional radiology (IR) area.  
• Surgical: A feeding tube can be placed in the operating room, either through small cuts (laparoscopic) or a larger cut (open surgery). 
• Endoscopic (PEG): A thin instrument with a camera (endoscope) can be used to guide the tube. 

The procedure your child gets depends on: 

• Their health and medical needs 
• Any other planned surgeries or procedures 
• What the hospital and care team can provide 

What to expect after feeding tube placement

After the tube is placed, your child will go to the recovery area to wake up after surgery. Most patients stay in the hospital for 1–2 days. At first, your child will get clear liquids through the tube.  

The tube will be held in place with tape or a special device. There may be gauze around the tube. Nurses will clean and change the gauze and tape as needed. You might see a little fluid around the tube for a few days. Your child may have some pain. Tell the care team so they can give medicine. Antibiotics may also be given to prevent infection. 

Your care team will teach you: 

• How to care for the feeding tube
• How to clean your child’s skin and care for the stoma. It is important to keep the tube and your child’s skin clean and free from infection. 
• What to do if the tube falls out or gets clogged. If the tube comes out, it needs to be replaced quickly because the stoma can close fast. 
• How to give formula, fluids, and medicine through the feeding tube 
• Problems to watch for 

A dietitian will make a feeding plan, select the formula, and monitor your child’s growth and nutrition. Most children can go back to normal activities when they feel better. 

After 6–8 weeks, the feeding tube may be changed to a smaller button or tube. 

Risks of feeding tubes

Children usually do well with feeding tubes, but feeding tube placement does have risks.  

During surgery, possible risks include: 

• Problems with anesthesia 
• Injury to nearby blood vessels, tissues, or organs 

After surgery, possible problems include: 

• Tube moving out of place 
• Tube getting blocked or leaking 
• Skin irritation around the tube 
• Infection 
• Problems with digestion, getting nutrients, or weight 

Serious problems are rare. Follow all care instructions to help prevent infection and keep the tube working. Ask your care team if any medicines need to be changed after the tube is placed. 

Care at home after feeding tube placement

Tips for caring for your child’s G-tube, J-tube, or GJ-tube include: 

• Wash your hands before touching the tube.  
• Clean the skin around the stoma every day with mild soap and water. 
• Secure the tube and make sure nothing pulls on it. 
• Flush the tube with warm water before and after feedings and giving medicines to prevent clogs. 
• Watch for problems such as redness, swelling, leaking, or pain around the stoma. Call your care team if you notice these signs. 
• Keep the area dry after cleaning. Change dressings or gauze as instructed. 
• Handle feedings safely. Follow your care team’s instructions for formula, medicines, and feeding schedules. 
• Check for leaks or blockages. If the tube seems blocked or leaking, do not force anything through it. Contact your care team. 

When to call your care team

Contact your child’s care team right away if you notice any of these problems: 

• You see redness, swelling, pain, or pus around the stoma. 
• Your child has a fever. 
• The tube falls out. 
• The tube is clogged or leaking. 
• There is bleeding or unusual fluid around the tube. 
• Your child has severe stomach pain, vomiting, or diarrhea. 
• You are unsure how to give feedings or medicines safely. 

Questions to ask your care team

• Why does my child need a feeding tube, and which type is best for them?  
• How will the tube be placed—image-guided, surgical, or endoscopic—and why?  
• What should we do to prepare for the procedure?  
• When does my child need to stop eating and drinking before feeding tube placement? 
• How long will my child stay in the hospital after the tube is placed?  
• What are the most common problems after placement, and how can we prevent them?  
• What should we do if the tube falls out or gets clogged?  
• When can my child return to normal activities like school or play? 
• Can my child eat while they have a feeding tube? 
• What activities should my child avoid while they have a feeding tube?  

المحتوى ذو الصلة