Scott R, Bowling T E
TE Bowling, Queen's Medical Centre Campus, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK. Email
J R Coll Physicians Edinb. 2015 Mar;45(1):49-54. doi: 10.4997/JRCPE.2015.112.
Enteral tube feeding is usually a relatively straightforward method of nutritional support, and should be facilitated by a multiprofessional team. For short-term use (<4 weeks) a fine bore feeding nasogastric tube is indicated but if longer term feeding is required then a gastrostomy is appropriate, usually inserted endoscopically (a percutaneous endoscopic gastrostomy tube). The most common serious complication of a nasogastric tube is not identifying a misplaced tube within the lungs: there are clear recommendations from the National Patient Safety Agency as to how to check tube placement. Nasojejunal tubes are required in patients with gastroparesis. Tube blockage is common and is prevented by careful and regular flushing. Diarrhoea is the most complication of feeding and is often related to other medication. Clinicians need an algorithm for systematically dealing with such a problem. Refeeding syndrome may occur in malnourished patients and is characterised by low levels of potassium, phosphate, and/or magnesium, as well as disorders of water and salt balance. Identifying the at-risk patient with careful monitoring is crucial.
肠内管饲通常是一种相对简单的营养支持方法，应由多专业团队协助进行。短期使用（<4周）时，建议使用细孔鼻胃饲管，但如果需要长期管饲，则胃造口术更为合适，通常通过内镜插入（经皮内镜下胃造口管）。鼻胃管最常见的严重并发症是未发现误插入肺部的导管：国家患者安全机构对如何检查导管位置有明确建议。胃轻瘫患者需要鼻空肠管。管堵塞很常见，可通过仔细定期冲洗来预防。腹泻是管饲最常见的并发症，通常与其他药物有关。临床医生需要一种系统处理此类问题的算法。再喂养综合征可能发生在营养不良的患者中，其特征是钾、磷酸盐和/或镁水平低，以及水盐平衡紊乱。通过仔细监测识别高危患者至关重要。
