<\/p>\n

M\u00fcasir d\u00f6vrd\u0259 praktikaya \u0259n yeni endoskopik texnologiyalar\u0131n daxil edilm\u0259si il\u0259 m\u00fct\u0259x\u0259ssisl\u0259r qastrostoman\u0131n qoyulmas\u0131 prosedurunun xeyli asanla\u015fd\u0131r\u0131lmas\u0131na nail olublar.<\/p>\n

Odur ki, Perkutan endoskopik qastrostomiya – uzunm\u00fcdd\u0259tli (3 h\u0259ft\u0259d\u0259n \u00e7ox) enteral zondla qidalanma t\u0259l\u0259b olunan hallarda (udma funksiyas\u0131 v\u0259 ya \u015f\u00fcurun b\u0259rpa olunmas\u0131 c\u0259h\u0259td\u0259n m\u00fcsb\u0259t proqnoz olmad\u0131\u011f\u0131 hallar) se\u00e7im \u00fcsuluna \u00e7evrilmi\u015fdir. Bu prosedurun apar\u0131lmas\u0131 \u00fc\u00e7\u00fcn \u0259sas \u015f\u0259rt a\u011f\u0131z-udlaq v\u0259 qida borusu ke\u00e7iriciliyinin normal saxlan\u0131lmas\u0131d\u0131r; \u0259ks halda c\u0259rrahlar, bir qayda olaraq, laparoskopik qastrotomiyaya m\u00fcraci\u0259t edirl\u0259r.<\/p>\n

Bundan \u0259lav\u0259 PEQ-n\u0131n icras\u0131na bir s\u0131ra dig\u0259r \u0259ks-g\u00f6st\u0259ri\u015fl\u0259r d\u0259 vard\u0131r: m\u0259d\u0259 v\u0259 onikibarmaq\u00a0ba\u011f\u0131rsa\u011f\u0131n peptik xoras\u0131, sepsis, peritonit, k\u0259skin assit, qanaxmaya meyllik, anatomik defektl\u0259r (iltihab v\u0259 ya \u0259vv\u0259lki c\u0259rrahi m\u00fcdaxil\u0259l\u0259r\u00a0n\u0259tic\u0259sind\u0259).<\/p>\n

Bu metodika il\u0259 qastrostoman\u0131n qoyulmas\u0131 iki h\u0259kim t\u0259r\u0259find\u0259n icra edilir. Ilk n\u00f6vb\u0259d\u0259 h\u0259kim ezofaqofibroqastroskopiya apararaq, m\u0259d\u0259nin \u00f6n divar\u0131nda minimal vaskulyarizasiyaya malik olan t\u0259hl\u00fck\u0259siz nahiy\u0259 se\u00e7ir.<\/p>\n

M\u0259d\u0259 kifay\u0259t q\u0259d\u0259r hava il\u0259 doldurulduqdan sonra prosedur apar\u0131lan otaqda qaranl\u0131q \u015f\u0259rait yarad\u0131l\u0131r. Endoskopun ucunu m\u0259d\u0259nin \u00f6n divar\u0131na dir\u0259n\u0259n\u0259 q\u0259d\u0259r yax\u0131nla\u015fd\u0131r\u0131rlar v\u0259 qarn\u0131n \u00f6n divar\u0131n\u0131n diafanoskopiyas\u0131 vasit\u0259sil\u0259 punksiya \u00fc\u00e7\u00fcn n\u0259z\u0259rd\u0259 tutulan yeri (ad\u0259t\u0259n a\u011f x\u0259ttd\u0259n k\u0259narda) ni\u015fanlay\u0131rlar v\u0259 qarn\u0131n \u00f6n divar\u0131na barmaqla basaraq d\u0259qiql\u0259\u015fdirirl\u0259r. \u00a0\u00a0\u00a0 $\"PEG\"$ <\/p>\n

Daha sonra m\u00fcvafiq \u0259m\u0259liyyat sah\u0259si antiseptikl\u0259rl\u0259 i\u015fl\u0259nir, qarn\u0131n \u00f6n divar\u0131n\u0131n b\u00fct\u00fcn qal\u0131nl\u0131\u011f\u0131\u00a0boyunca yerli anesteziyas\u0131 icra edilir v\u0259 se\u00e7ilmi\u015f n\u00f6qt\u0259d\u0259 ne\u015ft\u0259rl\u0259 d\u0259rid\u0259 k\u0259sik apar\u0131l\u0131r. Endoskopik n\u0259zar\u0259t alt\u0131nda perkutan olaraq m\u0259d\u0259 divar\u0131 troakarla punksiya edilir v\u0259 stilet xaric olunur. Troakar\u0131n kanyulas\u0131n\u0131 barmaqla fiks\u0259 ed\u0259r\u0259k m\u0259d\u0259y\u0259 uzun m\u00f6hk\u0259m sap kanyuladan sal\u0131n\u0131r. Sap biopsiya ma\u015falar\u0131 il\u0259 tutulur v\u0259 endoskop xaric edilir.<\/p>\n

Kanyuladan ke\u00e7irilmi\u015f sap qastrostomik kateterin konusundak\u0131 sapa ba\u011flan\u0131l\u0131b d\u00fcy\u00fcnl\u0259nir. Sap\u0131n k\u00f6m\u0259yi il\u0259 qastrostomik kateter m\u0259d\u0259y\u0259 bel\u0259 bir \u015f\u0259kild\u0259 yerl\u0259\u015fdirilir ki, onun plastik konusu troakar\u0131n kanyulas\u0131na s\u00f6yk\u0259nsin; v\u0259 kanyula il\u0259 birlikd\u0259 kateter m\u0259d\u0259nin v\u0259 qarn\u0131n divar\u0131ndan ke\u00e7irlir (al\u0259tin geni\u015f uc hiss\u0259si m\u0259d\u0259nin \u00f6n divar\u0131na s\u00f6yk\u0259n\u0259n\u0259 kimi). Qastrostomik zondun konusu fiks\u0259edici l\u00f6vh\u0259nin ortas\u0131ndak\u0131 d\u0259likd\u0259n, sonra is\u0259 tunelind\u0259n ke\u00e7irilir. L\u00f6vh\u0259, s\u0131x t\u0259sbit olunma hissi yaranana q\u0259d\u0259r, kateter boyunca ehtiyatla s\u00fcr\u00fc\u015fd\u00fcr\u00fcl\u00fcr. Prosedurun sonunda konus k\u0259silib at\u0131l\u0131r v\u0259 stoman\u0131n xarici ucuna kanyula birl\u0259\u015fdirilir ki, onun vasit\u0259sil\u0259 sonralar qidaland\u0131r\u0131c\u0131 m\u0259hlullar daxil olunacaq.<\/p>\n

Ilk h\u0259ft\u0259 \u0259rzind\u0259 sar\u011f\u0131 h\u0259r g\u00fcn, sonrak\u0131 d\u00f6vrd\u0259 is\u0259 g\u00fcna\u015f\u0131r\u0131 d\u0259yi\u015fdirilir.<\/p>\n

PEQ-d\u0259n sonrak\u0131 a\u011f\u0131rla\u015fmalar\u0131n tezliyi 0,8%-d\u0259n \u00e7ox olmur. \u018fsas probleml\u0259r qastrostomik borunun qoyulmas\u0131, maye, qidan\u0131n t\u0259n\u0259ff\u00fcs yollar\u0131na aspirasiyas\u0131 il\u0259 \u0259laq\u0259dar yaran\u0131r. \u00c7ox nadir hallarda dig\u0259r orqanlar\u0131n z\u0259d\u0259l\u0259nm\u0259si, qar\u0131nda k\u00f6p, \u00fcr\u0259kbulanma, diareya, boru\u0259traf\u0131 d\u0259ri nahiy\u0259sind\u0259 iltihab, infeksion proses, q\u0131c\u0131qlanma yarana bil\u0259r. A\u011f\u0131rla\u015fmalar riskinin birba\u015fa as\u0131l\u0131 oldu\u011fu faktorlar bunlard\u0131r: \u015f\u0259k\u0259rli diabetin olmas\u0131, ah\u0131l ya\u015f, alkoholdan sui istifad\u0259, narkotikl\u0259rin q\u0259bulu, yax\u0131n zamanda qar\u0131n bo\u015flu\u011funda \u0259m\u0259liyyatlar\u0131n ke\u00e7irilm\u0259si.<\/p>\n

https:\/\/www.youtube.com\/watch?v=YjkZ6mQJ4JU<\/a><\/p>\n

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[:]<\/p>\n","protected":false},"excerpt":{"rendered":"