Wallstabe I, Tiedemann A, Schiefke I, Weimann A
Klinik für Gastroenterologie und Hepatologie, Klinikum St. Georg gGmbH, Delitzscher Str. 141, 04129, Leipzig, Deutschland.
Chirurg. 2013 Jul;84(7):559-65. doi: 10.1007/s00104-012-2409-4.
Standardized management of oncology patients necessarily includes screening for nutritional risk. Weight loss of > 5 kg within 3 months and diminished food intake are warning signals even in overweight patients. In case oral nutrition is neither adequate nor feasible even by fortification or oral nutritional supplements, the implantation of a percutaneous endoscopic gastrostomy (PEG) or fine needle catheter jejunostomy (FNCJ) offers enteral access for long-term nutritional support. Although the indications derive from fulfilling caloric needs, endoscopic or operative measures are not considered to be an urgent or even emergency measure. The endoscopist or surgeon should be fully aware and informed of the indications and make a personal assessment of the situation. The implantation of a feeding tube requires informed consent of the patient or legal surrogates. The review summarizes recent indications, technical problems and complications.
肿瘤患者的标准化管理必然包括营养风险筛查。即使是超重患者,3个月内体重减轻超过5kg以及食物摄入量减少都是警示信号。如果通过强化饮食或口服营养补充剂仍无法实现充足或可行的口服营养,经皮内镜下胃造口术(PEG)或细针导管空肠造口术(FNCJ)的植入可为长期营养支持提供肠内通路。尽管适应证源于满足热量需求,但内镜或手术措施不被视为紧急或急诊措施。内镜医师或外科医生应充分了解适应证并对情况进行个人评估。喂养管的植入需要患者或法定代理人的知情同意。本综述总结了近期的适应证、技术问题和并发症。