Trimpe Kaleena, Shaw Michele R, Wilson Marian, Haberman Mel R
1 Washington State University, Spokane, WA, USA.
J Pediatr Oncol Nurs. 2017 Nov/Dec;34(6):439-445. doi: 10.1177/1043454217712982. Epub 2017 Jul 12.
Enteral supplementation for nutritional support in pediatric oncology patients remains nonstandardized across institutions and between providers. Pediatric oncology patients frequently fail to meet their growth curve percentiles, lose weight, and/or are malnourished due to both the oncologic process as well as side effects from chemotherapy and radiation treatments. Methods of increasing weight include enteral feeding (nasogastric, nasoduodenal/jejunal, or gastrostomy), parenteral intravenous feeding, and oral supplementation. Indications for feeding and feeding protocols are highly variable, in part due to parental and familial choices, and in part due to the lack of guidelines available for providers. This article provides a comprehensive literature review of 8 published studies regarding the effectiveness and safety of enteral feeding in maintaining or increasing weight in pediatric oncology patients to help inform practice. The review concludes that enteral feeding in pediatric oncology patients is an effective and safe method to affect weight positively. However, further research is needed for developing treatment guidelines, including establishing a timeline for initiation of feeding, and determining which patients are most likely to benefit from enteral feeding.
在儿科肿瘤患者中，肠内营养补充用于营养支持在各机构之间以及不同医疗服务提供者之间仍未标准化。儿科肿瘤患者常常无法达到其生长曲线百分位数，体重减轻，和/或由于肿瘤病程以及化疗和放疗的副作用而出现营养不良。增加体重的方法包括肠内喂养（鼻胃管、鼻十二指肠/空肠管或胃造口术）、肠外静脉喂养和口服补充。喂养指征和喂养方案差异很大，部分原因是家长和家庭的选择，部分原因是医疗服务提供者缺乏可用的指南。本文对8项已发表的关于肠内喂养对儿科肿瘤患者维持或增加体重的有效性和安全性的研究进行了全面的文献综述，以帮助指导实践。综述得出结论，儿科肿瘤患者的肠内喂养是一种有效且安全的积极影响体重的方法。然而，制定治疗指南还需要进一步研究，包括确定开始喂养的时间线，以及确定哪些患者最有可能从肠内喂养中获益。
