Baskin W N
University of Illinois College of Medicine, Rockford.
Am J Gastroenterol. 1992 Nov;87(11):1547-53.
The increasing use of enteral nutrition in hospitals has led to an expanded role for the gastroenterologist and surgeon in providing enteral access. New concepts in immunonutrition and gut support in critically ill patients have popularized early postoperative feeding. There is an ongoing need to update physicians on the diverse enteral access techniques now available. In addition to standard percutaneous endoscopic gastrostomy (PEG) and percutaneous endoscopic jejunostomy (PEJ) techniques, this review focuses on reflux prevention through double-lumen feeding-suction tubes, and describes the use of steerable catheters for rapid insertion of nasojejunal and PEJ tubes without endoscopy. Low-profile "button"-type devices, one-step button placement, replacement gastrostomy devices, and special enteral techniques for patients with cancer are also reviewed.
医院中肠内营养使用的增加，使得胃肠病学家和外科医生在提供肠内通路方面的作用得到了扩展。危重症患者免疫营养和肠道支持的新概念，使术后早期喂养得到普及。持续需要让医生了解目前可用的各种肠内通路技术。除了标准的经皮内镜下胃造口术（PEG）和经皮内镜下空肠造口术（PEJ）技术外，本综述重点关注通过双腔喂养-吸引管预防反流，并描述了使用可操纵导管在无需内镜检查的情况下快速插入鼻空肠管和PEJ管的方法。还综述了低轮廓“纽扣”型装置、一步纽扣置入、更换胃造口装置以及针对癌症患者的特殊肠内技术。
