Neiderman M, Zarody M, Tattersall M, Lask B
Eating Disorders Service, Huntercombe Manor Hospital, Maidenhead, United Kingdom.
Int J Eat Disord. 2000 Dec;28(4):470-5. doi: 10.1002/1098-108x(200012)28:4<470::aid-eat18>3.0.co;2-1.
Refeeding patients with anorexia nervosa can be one of the more challenging aspects of their treatment, and particularly if all food and fluids are adamantly and persistently refused.
If the decision is made to augment or replace oral feeds, the most common intervention is nasogastric feeding.
Although this is often successful, a subset of patients manage to sabotage feeding via this route. Other means of delivering nutrition such as intravenous feeds are often impractical for long-term use. Another alternative in such life-threatening situations is the use of enteric feeds via gastrostomy or jejunostomy. This paper presents the successful use of such enteric feeding in four cases of severe adolescent anorexia nervosa.
The psychological, legal, and ethical issues involved are discussed, concluding that gastrostomy and jejunostomy are valid lifesaving methods to feed highly resistant anorectic patients.
对神经性厌食症患者进行重新喂食可能是其治疗中较具挑战性的方面之一，尤其是当所有食物和液体都被坚决且持续拒绝时。
如果决定增加或替代经口喂养，最常见的干预措施是鼻饲。
尽管这通常是成功的，但有一部分患者设法通过这种途径破坏喂养。其他提供营养的方式，如静脉喂养，长期使用往往不切实际。在这种危及生命的情况下的另一种选择是通过胃造口术或空肠造口术进行肠内喂养。本文介绍了在4例严重青少年神经性厌食症患者中成功使用这种肠内喂养的情况。
文中讨论了所涉及的心理、法律和伦理问题，得出结论认为胃造口术和空肠造口术是喂养高度抗拒进食的厌食症患者的有效救生方法。
