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置管喂养:失误与并发症。

Feeding tube placement: errors and complications.

机构信息

Department of Internal Medicine, University of Utah, Salt Lake City, Utah 84132, USA.

出版信息

Nutr Clin Pract. 2012 Dec;27(6):738-48. doi: 10.1177/0884533612462239. Epub 2012 Oct 12.

Abstract

Feeding tube placement for enteral nutrition (EN) support is widely used in both critically ill and stable chronically ill patients who are unable to meet their nutrition needs orally. Nasal or oral feeding tubes can be performed blindly at the bedside or with fluoroscopic or endoscopic guidance into the stomach or small bowel. Percutaneous feeding tubes are used when EN support is required for longer periods (>4-6 weeks) and are most commonly placed endoscopically or radiographically. Although generally safe and effective, there is a wide spectrum of known complications associated with feeding tube placement. Errors made at the time of feeding tube placement can result in a number of these procedural and postprocedural complications. In many cases, a single error at the time of placement can result in numerous complications. A thorough knowledge of these errors and avoiding them in practice will decrease iatrogenic complications in a vulnerable population. In addition, early recognition and management of complications will further minimize morbidity and even mortality in enteral feeding tube placement. This article reviews the common errors leading to complications of enteral feeding tube placement and their prevention and management.

摘要

肠内营养(EN)支持的喂养管放置在无法经口满足营养需求的危重症和稳定慢性病患者中广泛应用。鼻饲或口服喂养管可以在床边进行盲插,也可以在透视或内镜引导下插入胃或小肠。当需要更长时间(>4-6 周)的 EN 支持时,使用经皮喂养管,最常用于内镜或放射学引导下放置。尽管通常安全有效,但与喂养管放置相关的并发症种类繁多。在喂养管放置时出现的错误可能导致许多程序和程序后并发症。在许多情况下,放置时的一个单一错误就可能导致许多并发症。深入了解这些错误并在实践中避免它们,将减少脆弱人群的医源性并发症。此外,早期识别和处理并发症将进一步最大限度地减少肠内喂养管放置的发病率,甚至死亡率。本文回顾了导致肠内喂养管放置并发症的常见错误及其预防和管理。

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