Instituto Sírio-Libanês de Ensino e Pesquisa, São Paulo, Brazil.
Sírio-Libanês Hospital, São Paulo, Brazil.
Eur J Clin Nutr. 2020 Feb;74(2):261-267. doi: 10.1038/s41430-019-0475-0. Epub 2019 Jul 30.
BACKGROUND/OBJECTIVES: Obstruction of the nasoenteral tube is one of the complications of enteral nutrition therapy, and its causes and frequency of occurrence are not well understood. To evaluate the causes of enteral nutrition feeding tube obstruction. To study the time elapsed between the beginning of the nutrition therapy and the obstruction of the tube.
SUBJECTS/METHODS: This was a retrospective cohort study of 1170 patients aged 18 years or older who were hospitalized at Sírio-Libanês Hospital between January 2015 and October 2017, and who were undergoing enteral nutrition therapy delivered using an infusion pump through a nasogastric or nasoenteral tube. The study population included 683 (58%) men and 487 (42%) women. The median age was 79 years. Of these, 1084 patients received enteral nutrition and medication through the feeding tube, and 86 received medication alone. Variables investigated as causes of feeding tube obstruction were the administration of medication through the tube, type of diet, and use of symbiotics.
Obstruction rates were 4% for up to 40 days of observation and 8% for the total observation time. The time for obstruction of 10% of the tubes in patients receiving rivaroxaban, linagliptin, metformin, and nystatin was 16, 19, 20, and 28 days, respectively.
The main cause of nasoenteral tube obstruction (odds ratio) was the combination of metformin (2.0), nystatin (3.1), linagliptin (4.3), rivaroxaban (2.4), and a high-protein diet (1.9). Overall, proper tube care and strict compliance with tubal drug delivery guidelines can result in low tube obstruction rates.
背景/目的：肠内营养治疗的并发症之一是鼻肠管阻塞，其原因和发生频率尚不清楚。评估肠内营养喂养管阻塞的原因。研究从开始营养治疗到管腔阻塞之间的时间间隔。
受试者/方法：这是一项回顾性队列研究，纳入了 2015 年 1 月至 2017 年 10 月期间在 Sírio-Libanês 医院住院的 1170 名年龄在 18 岁或以上的患者，这些患者通过输注泵经鼻胃管或鼻肠管进行肠内营养治疗。研究人群包括 683 名（58%）男性和 487 名（42%）女性，中位年龄为 79 岁。其中，1084 名患者通过喂养管接受肠内营养和药物治疗，86 名患者仅接受药物治疗。将通过管给药、饮食类型和使用共生菌作为管阻塞的原因进行了调查。
在 40 天的观察期内，阻塞率为 4%，总观察时间内的阻塞率为 8%。接受利伐沙班、利格列汀、二甲双胍和制霉菌素治疗的患者中，10%的管腔阻塞时间分别为 16、19、20 和 28 天。
鼻肠管阻塞的主要原因（比值比）是二甲双胍（2.0）、制霉菌素（3.1）、利格列汀（4.3）、利伐沙班（2.4）和高蛋白饮食（1.9）的联合使用。总的来说，适当的管护理和严格遵守管内药物输送指南可以降低管阻塞率。
