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家庭管饲婴儿的结局:鼻胃管与胃造口管的比较。

Outcomes of Infants With Home Tube Feeding: Comparing Nasogastric vs Gastrostomy Tubes.

机构信息

1 Division of Neonatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

2 Division of Pediatric Gastroenterology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

出版信息

JPEN J Parenter Enteral Nutr. 2017 Nov;41(8):1380-1385. doi: 10.1177/0148607116670621. Epub 2016 Sep 19.

Abstract

BACKGROUND

The aim of this study was to determine the tube-related complications and feeding outcomes of infants discharged home from the neonatal intensive care unit (NICU) with nasogastric (NG) tube feeding or gastrostomy (G-tube) feeding.

MATERIALS AND METHODS

We performed a chart review of 335 infants discharged from our NICU with home NG tube or G-tube feeding between January 2009 and December 2013. The primary outcome was the incidence of feeding tube-related complications requiring emergency department (ED) visits, hospitalizations, or deaths. Secondary outcome was feeding status at 6 months postdischarge. Univariate and multivariate analyses were conducted.

RESULTS

There were 322 infants discharged with home enteral tube feeding (NG tube, n = 84; G-tube, n = 238), with available outpatient data for the 6-month postdischarge period. A total of 115 ED visits, 28 hospitalizations, and 2 deaths were due to a tube-related complication. The incidence of tube-related complications requiring an ED visit was significantly higher in the G-tube group compared with the NG tube group (33.6% vs 9.5%, P < .001). Two patients died due to a G-tube-related complication. By 6 months postdischarge, full oral feeding was achieved in 71.4% of infants in the NG tube group compared with 19.3% in the G-tube group ( P < .001). Type of feeding tube and percentage of oral feeding at discharge were significantly associated with continued tube feeding at 6 months postdischarge.

CONCLUSION

Home NG tube feeding is associated with fewer ED visits for tube-related complications compared with home G-tube feeding. Some infants could benefit from a trial home NG tube feeding.

摘要

背景

本研究旨在确定患有经鼻胃管(NG)喂养或胃造口术(G 管)喂养的婴儿从新生儿重症监护病房(NICU)出院回家后的与管饲相关的并发症和喂养结局。

材料与方法

我们对 2009 年 1 月至 2013 年 12 月期间从我们的 NICU 出院回家进行 NG 管或 G 管喂养的 335 名婴儿进行了图表回顾。主要结局是需要急诊科(ED)就诊、住院或死亡的与喂养管相关的并发症发生率。次要结局是出院后 6 个月的喂养状态。进行了单变量和多变量分析。

结果

共有 322 名婴儿出院时在家中接受肠内喂养管(NG 管,n = 84;G 管,n = 238),可获得出院后 6 个月的门诊数据。共发生 115 次 ED 就诊、28 次住院和 2 例死亡,均与管相关并发症有关。与 NG 管组相比,G 管组需要 ED 就诊的管相关并发症发生率显著更高(33.6% vs 9.5%,P <.001)。两名患者因 G 管相关并发症死亡。出院后 6 个月,NG 管组有 71.4%的婴儿实现了完全口服喂养,而 G 管组仅为 19.3%(P <.001)。喂养管类型和出院时的口服喂养比例与出院后 6 个月的持续管饲显著相关。

结论

与家庭 G 管喂养相比,家庭 NG 管喂养与管相关并发症的 ED 就诊次数更少。一些婴儿可能受益于家庭 NG 管喂养的尝试。

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