Department of Paediatric Surgery and urology, Children's Services, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Curr Opin Pediatr. 2018 Oct;30(5):665-670. doi: 10.1097/MOP.0000000000000666.
A practical guide to different feeding tubes available for nutritional support in children, focused on indications, placement methods and complications.
Enteral nutritional support refers to the delivery of nutrition into the gastrointestinal tract distal to the oesophagus. Different feeding tubes are available for exclusive or supplemental nutritional support in children who are unable to independently sustain their own growth, nutritional and hydration status. Gastric feeding is the first choice; however, jejunal feeding provides a good alternative route in the presence of contraindications or intolerance. Feeding tubes can be short or long term: nasogastric and nasojejunal tubes provide short-term nutrition support, gastrostomy and jejunostomy tubes, long-term enteral feeding. The latter are established surgically through the formation of a stoma, an artificial connection between gastric or jejunal lumen and the abdominal wall, performed either endoscopically (percutaneous endoscopic gastrostomy, percutaneous endoscopic gastrojejunostomy) or surgically (gastrostomy, direct jejunostomy). Awareness of different available options, technical considerations and potential risks will inform the decision-making process for an individual patient to ensure the correct balance between adequate enteral nutritional and unnecessary morbidity.
Successful administration of nutrition support requires knowledge of the correct indication, route and specific functional details of the appropriate feeding tube.
介绍了不同类型的喂养管在儿童营养支持中的应用，重点介绍了适应证、置管方法和并发症。
肠内营养支持是指将营养物质输送到食管远端的胃肠道。对于不能自主维持生长、营养和水合状态的儿童，有不同类型的喂养管可用于提供完全或补充性的营养支持。胃内喂养是首选方法；然而，在存在禁忌证或不耐受的情况下，肠内喂养是一个较好的替代途径。喂养管可以是短期或长期的：鼻胃管和鼻空肠管提供短期营养支持，胃造口管和空肠造口管则提供长期肠内喂养。后者通过造口术建立，即在胃或空肠腔与腹壁之间形成一个人工连接，可通过内镜（经皮内镜胃造口术、经皮内镜胃肠造口术）或手术（胃造口术、直接空肠造口术）完成。了解不同的可用选择、技术考虑因素和潜在风险将为个体患者的决策过程提供信息，以确保在充分的肠内营养和不必要的发病率之间取得正确的平衡。
成功实施营养支持需要了解正确的适应证、途径和适当喂养管的特定功能细节。
