Watson A R, Coleman J E, Taylor E A
Paediatric Renal Unit, City Hospital, Nottingham, UK.
Adv Perit Dial. 1992;8:391-5.
The promotion of growth in infants and young children with chronic renal failure (CRF) requires an aggressive approach to feeding, often in combination with early dialysis. Supplementary feeding has usually involved the use of nasogastric tubes, but these can have many problems. We report our experience with a gastrostomy button device (Bard Ltd.) for long term feeding. Ten children (7 male) had an initial gastrostomy catheter inserted at a median age of 2.0 years (range 0.25-8.5 years). None of the children required an operation for gastrooesophageal reflux and 6 had placement of the gastrostomy catheter at the time of insertion of the Tenckhoff catheter for continuous cycling peritoneal dialysis (CCPD). The catheter is usually exchanged for a similar sized (18 gauge) button device after 4 weeks. All ten children received CCPD in addition to overnight feeding using an enteral feeding pump. The buttons have been in use for a mean of 12 months (range 2-33 months) and are only changed if the anti-reflux valves fail. Nutritional goals have been achieved and growth parameters maintained or improved in 9 children. The button has many advantages over nasogastric tubes or gastrostomy catheters. It has been welcomed by our families in reducing the stress of feeding these young children.
促进慢性肾衰竭（CRF）婴幼儿的生长需要积极的喂养方法，通常还需结合早期透析。补充喂养通常采用鼻胃管，但鼻胃管存在诸多问题。我们报告了使用胃造口纽扣装置（巴德有限公司）进行长期喂养的经验。10名儿童（7名男性）首次插入胃造口导管的中位年龄为2.0岁（范围0.25 - 8.5岁）。所有儿童均无需因胃食管反流而进行手术，6名儿童在插入Tenckhoff导管进行持续循环腹膜透析（CCPD）时同时放置了胃造口导管。4周后，导管通常会更换为尺寸相近（18号）的纽扣装置。所有10名儿童除了使用肠内喂养泵进行夜间喂养外，还接受了CCPD。这些纽扣装置平均使用了12个月（范围2 - 33个月），只有在抗反流瓣膜出现故障时才会更换。9名儿童实现了营养目标，生长参数得以维持或改善。与鼻胃管或胃造口导管相比，纽扣装置具有许多优点。它减轻了喂养这些幼儿的压力，受到了我们患儿家庭的欢迎。
