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肠内管饲喂养

[Enteral tube feeding].

作者信息

Haller Alois

机构信息

Zentrum für Intensivmedizin, Kantonsspital Winterthur.

出版信息

Ther Umsch. 2014 Mar;71(3):155-61. doi: 10.1024/0040-5930/a000497.

Abstract

Tube feeding is an integral part of medical therapies, and can be easily managed also in the outpatient setting. Tube feeding by the stomach or small intestine with nasogastral or nasojejunal tubes is common in clinical practice. Long-term nutrition is usually provided through a permanent tube, i. e. a percutaneous endoscopic gastrostomy (PEG). Modern portable nutrition pumps are used to cover the patient's nutritional needs. Enteral nutrition is always indicated if patients can not or should not eat or if nutritional requirements cannot be covered within 3 days after an intervention, e. g. after abdominal surgery. Industrially produced tube feedings with defined substrate concentrations are being used; different compositions of nutrients, such as glutamine fish oil etc., are used dependent on the the condition of the patient. Enteral nutrition may be associated with complications of the tube, e. g. dislocation, malposition or obstruction, as well as the feeding itself, e. g.hyperglycaemia, electrolyte disturbances, refeeding syndrome diarrhea or aspiration). However, the benefit of tube feeding usually exceeds the potential harm substantially.

摘要

管饲是医学治疗的一个重要组成部分,在门诊环境中也易于管理。在临床实践中,通过鼻胃管或鼻空肠管经胃或小肠进行管饲很常见。长期营养通常通过永久性管道提供,即经皮内镜下胃造口术(PEG)。现代便携式营养泵用于满足患者的营养需求。如果患者不能或不应进食,或者在干预(如腹部手术后)3天内无法满足营养需求,则总是需要进行肠内营养。目前使用的是工业生产的具有特定底物浓度的管饲产品;根据患者的情况使用不同营养成分,如谷氨酰胺、鱼油等。肠内营养可能会伴有管道相关并发症,如移位、位置不当或堵塞,以及喂养本身相关的并发症,如高血糖、电解质紊乱、再喂养综合征、腹泻或误吸。然而,管饲的益处通常大大超过潜在危害。

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