Egnell Christina, Eksborg Staffan, Grahnquist Lena
Pediatric Gastroenterology, Hepatology and Nutrition, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Pediatric Gastroenterology, Hepatology and Nutrition, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
JPEN J Parenter Enteral Nutr. 2014 Jul;38(5):631-6. doi: 10.1177/0148607113489832. Epub 2013 May 30.
The aim of this study was to report on the clinical outcome and safety of jejunostomy tube feeding used in our clinical setting for more than 14 years.
A retrospective study of all children who underwent a surgical catheter jejunostomy placement between July 1996 and March 2010 was conducted. Data were collected regarding the outcome and complications.
Thirty-three children (14 girls) were included. The median age at the time of primary surgery was 1.43 years (range, 0.15-17.7 years), and the median time of follow-up was 2.34 years (range, 0.27-12.6 years). Seventeen children were severely neurologically impaired (NI). Surgical insertion of a jejunostomy tube was performed due to 1 or more of the following indications: gastroesophageal reflux disease (GERD), failure to thrive, recurrent pneumonia, esophageal disease, or oral feeding difficulties. The effect of the indications showed a reduction in GERD and pneumonia. Feeding difficulties also decreased. Weaning was possible in 12 of 16 children without NI but in only 2 of 17 with NI. Major complications requiring surgical reoperation affected 8 children. No mortality was related to the jejunostomy feeding catheter.
In selected cases, surgically placed jejunostomy tubes for feeding in children is an effective and safe method to overcome GERD, feeding difficulties, or recurrent pneumonia without major surgery.
本研究旨在报告在我们临床环境中使用超过14年的空肠造口管喂养的临床结果和安全性。
对1996年7月至2010年3月期间接受手术放置空肠造口导管的所有儿童进行回顾性研究。收集有关结果和并发症的数据。
纳入33名儿童（14名女孩）。初次手术时的中位年龄为1.43岁（范围0.15 - 17.7岁），中位随访时间为2.34年（范围0.27 - 12.6年）。17名儿童有严重神经功能障碍（NI）。因以下一种或多种指征进行空肠造口管手术置入：胃食管反流病（GERD）、生长发育不良、反复肺炎、食管疾病或经口喂养困难。这些指征的效果显示GERD和肺炎有所减轻。喂养困难也有所减少。16名无NI的儿童中有12名可以断奶，但17名有NI的儿童中只有2名可以断奶。需要再次手术的主要并发症影响了8名儿童。没有死亡与空肠造口喂养导管相关。
在选定的病例中，手术放置空肠造口管用于儿童喂养是一种有效且安全的方法，可在不进行大手术的情况下克服GERD、喂养困难或反复肺炎。
