Kalita Monika, Majewska Krystyna, Gradowska Aleksandra, Karwowska Katarzyna, Ławiński Michał
Pol Przegl Chir. 2015 Feb 3;86(10):466-72. doi: 10.2478/pjs-2014-0083.
Home enteral nutrition (HEN for short) allows practically normal living for patients who cannot be fed orally but at the same time do not have to stay in hospitals, which is often found to decrease their mental condition, increase of probability of complications and costs of medical treatment. The aim of the study was to analyze the frequency of nutritional, mechanical and septic complications in patients fed enterally in home conditions.
The study performed using retrospective analysis of study results and reports from control visits for patients in the period between 2012-2013. 147 patients fed enterally using HEN method participated in the study, including 70 men and 77 women aged 19 to 99 years (average 65 years). The following type of gastrointestinal tract access was used for patients: PEG in 113 (76.5%), feeding jejunostomy - 21 (1.4%), PEG-PEJ - 5 (3.5%), in case of the remaining 8 patients the nasogastric gavage (5.5%) was used.
The most common complication were infections (of gastric tract, skin soft tissue in the region of nutritional fistula entry, in three cases the aspiration pneumonia was diagnosed) found in 55 (49.1%) of cases. Mechanical complications were found out in 29 (25.9% of all complications), nutritional complications were present 28 times, which constituted 25% of all complications.
In the studied group of patients with an implemented HEN procedure, septic complications were the most common problem. The longest average nutrition time with PEG-PEJ probably results from the effective protection of the patient against aspiration pneumonia.
家庭肠内营养（简称HEN）使无法经口进食但又无需住院的患者能够过上几乎正常的生活，而住院往往会导致患者精神状态下降、并发症发生几率增加以及医疗费用上升。本研究的目的是分析在家中接受肠内营养患者的营养、机械性和感染性并发症的发生频率。
本研究采用回顾性分析研究结果以及2012 - 2013年期间患者对照访视报告的方法。147例采用HEN方法接受肠内营养的患者参与了研究，其中包括70名男性和77名女性，年龄在19至99岁之间（平均65岁）。患者采用了以下类型的胃肠道通路：113例（76.5%）采用经皮内镜下胃造口术（PEG），21例（1.4%）采用空肠造口喂养，5例（3.5%）采用PEG - PEJ（经皮内镜下胃造口 - 空肠造口术），其余8例（5.5%）采用鼻胃管灌食。
最常见的并发症是感染（胃肠道感染、营养瘘口处皮肤软组织感染，3例诊断为吸入性肺炎），55例（49.1%）出现此类情况。发现机械性并发症29例（占所有并发症的25.9%），营养并发症出现28次，占所有并发症的25%。
在实施HEN程序的研究患者组中，感染性并发症是最常见的问题。PEG - PEJ的平均营养时间最长，这可能是因为该方法能有效保护患者预防吸入性肺炎。
