Nishiwaki Shinji, Araki Hiroshi, Shirakami Yohei, Kawaguchi Junji, Kawade Naofumi, Iwashita Masahide, Tagami Atsushi, Hatakeyama Hiroo, Hayashi Takao, Maeda Teruo, Saitoh Koushirou
Department of Internal Medicine, Nishimino Kosei Hospital, and Department of Gastroenterology, Graduate School of Medicine, Gifu University, Oshikoshi 986, Yoro-cho, Yoro-gun, Gifu 503-1394, Japan.
JPEN J Parenter Enteral Nutr. 2009 Sep-Oct;33(5):513-9. doi: 10.1177/0148607108327045. Epub 2009 Jun 1.
Aspiration is one of the major complications after percutaneous endoscopic gastrostomy (PEG). The administration of semi-solid nutrients by means of gastrostomy tube has recently been reported to be effective in preventing aspiration pneumonia. The effects of semi-solid nutrients on gastroesophageal reflux, intragastric distribution, and gastric emptying were evaluated.
Semi-solid nutrients were prepared by liquid nutrients mixed with agar at the concentration of 0.5%. The distribution of the administered radiolabeled liquid and semi-solid nutrients was monitored by a scintillation camera for 15 post-PEG patients. The percentage of esophageal reflux, the distribution of the proximal and distal stomach, and the gastric emptying time were evaluated.
The percentage of gastroesophageal reflux was significantly decreased in semi-solid nutrients (0.82 +/- 1.27%) compared with liquid nutrients (3.75 +/- 4.25%), whereas the gastric emptying time was not different. The distribution of semi-solid nutrients was not different from liquid nutrients in the early phase, whereas higher retention of liquid nutrients in the proximal stomach was observed in the late phase.
Gastroesophageal reflux was significantly inhibited by semi-solid nutrients. One of the mechanisms of the inhibition is considered to be an improvement in the transition from the proximal to distal stomach in semi-solid nutrients.
误吸是经皮内镜下胃造口术（PEG）后的主要并发症之一。最近有报道称，通过胃造口管给予半固体营养物对预防误吸性肺炎有效。本研究评估了半固体营养物对胃食管反流、胃内分布及胃排空的影响。
将液体营养物与浓度为0.5%的琼脂混合制备半固体营养物。用闪烁照相机监测15例PEG术后患者摄入放射性标记的液体和半固体营养物后的分布情况。评估食管反流百分比、胃近端和远端的分布情况以及胃排空时间。
与液体营养物（3.75±4.25%）相比，半固体营养物的胃食管反流百分比显著降低（0.82±1.27%），而胃排空时间无差异。早期半固体营养物的分布与液体营养物无差异，但后期观察到液体营养物在胃近端的潴留较多。
半固体营养物可显著抑制胃食管反流。其抑制机制之一被认为是半固体营养物从胃近端向远端转运的改善。
