Jiang Weiwei, Zhang Jie, Lv Xiaofeng, Xu Xiaoqun, Geng Qiming, Tang Weibing
Department of Neonatal Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.
Department of Neonatal Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China. Email:
Asia Pac J Clin Nutr. 2018;27(2):313-317. doi: 10.6133/apjcn.032017.21.
The stoma of intermediate position enterostomy (IPE) often leads to high output, which is related to electrolyte abnormalities, and prolongs patient recovery post-operatively. The continuous nasogastric tube feeding method has the advantage of reducing the risk of feeding intolerance, and improves nutrient absorption. In the current study, we review our experience with continuous tube feeding and compare the clinical outcomes with intermittent oral feeding in patients with an IPE post-operatively.
This was a retrospective review of 118 infants with IPEs in our hospital. The infants were categorized into two groups (intermittent oral feeding [OF] group [n=68 infants, 1-14 days of age] and continuous tube feeding [TF] group [n=50 infants, 1-14 days of age]). Differences in stool volume, daily intravenous fluid infusion, weight gain, nutrition indices, and post-operative complications were reviewed.
The stool volume and intravenous fluid infusion in the TF group were less than the OF group from week 2. The weight gain was higher in the TF group than the OF group from week 3. The pre-albumin and retinol binding protein levels were significantly higher in the TF group than the OF group in weeks 3-4 post-operatively. The incidence of cholestasis and waterelectrolyte disturbances in the TF group was significantly lower than the OF group, and the incidence of intestinal obstruction was lower than the control group, but the differences were not significant.
Continuous tube feeding had better clinical outcomes than intermittent oral feeding in IPE patients.
中位肠造口术(IPE)的造口常常导致高排出量,这与电解质异常相关,并会延长患者术后恢复时间。持续鼻饲管喂养法具有降低喂养不耐受风险的优势,且能改善营养吸收。在本研究中,我们回顾了持续管饲的经验,并比较了IPE术后患者持续管饲与间歇性口服喂养的临床结果。
这是一项对我院118例IPE婴儿的回顾性研究。婴儿被分为两组(间歇性口服喂养[OF]组[n = 68例婴儿,1 - 14日龄]和持续管饲[TF]组[n = 50例婴儿,1 - 14日龄])。回顾了粪便量、每日静脉输液量、体重增加、营养指标及术后并发症的差异。
从第2周起,TF组的粪便量和静脉输液量少于OF组。从第3周起,TF组的体重增加高于OF组。术后3 - 4周,TF组的前白蛋白和视黄醇结合蛋白水平显著高于OF组。TF组胆汁淤积和水电解质紊乱的发生率显著低于OF组,肠梗阻发生率低于对照组,但差异无统计学意义。
在IPE患者中,持续管饲比间歇性口服喂养具有更好的临床结果。