Clinical Nurse Specialist/Senior Researcher, Department of Hepatology and Gastroenterology, Aarhus University Hospital, Denmark.
Liver Nurse, Department of Hepatology and Gastroenterology, Aarhus University Hospital, Denmark.
Br J Nurs. 2020 Nov 12;29(20):1148-1154. doi: 10.12968/bjon.2020.29.20.1148.
Malnutrition and muscle mass loss are complications in liver cirrhosis and alcoholic hepatitis (AH). Hospitalised patients who do not meet nutritional requirements are recommended to be fed enterally or parenterally, but no guidelines recommend a specific type of tube. This study aimed to compare the efficacy of jejunal versus gastric feeding.
40 inpatients with liver cirrhosis and/or AH, a nutritional risk score more than 2 and a reduced daily energy intake were included. Half were randomised to nasogastric (NG) and half to nasojejunal (NJ) tube feeding. All received Peptamen AF as a supplement to oral intake. Participants were followed up until discharge or death.
The study evaluated the data for 33 patients for 7 days after tube insertion. Mean daily energy intake for 7 days was 6509 kJ (NG) vs 6605kJ (NJ) (=0.90). Tubes accidently removed by patients: once (=16); twice (=9); three times (=6), with no differences between NG and NJ.
There were no significant differences in total nutritional intake between early NG feeding and early NJ feeding 7 days after tube insertion. The number of tube replacements was similar in both groups. Choice of tubes for patients with severe liver disease will depend on individual patient characteristics and needs and local facilities.
营养不良和肌肉质量损失是肝硬化和酒精性肝炎（AH）的并发症。建议不能满足营养需求的住院患者进行肠内或肠外喂养，但没有指南推荐特定类型的管饲。本研究旨在比较空肠与胃饲的疗效。
纳入 40 例肝硬化和/或 AH 住院患者，营养风险评分>2 分且每日能量摄入减少。一半患者随机分为鼻胃管（NG）组，一半为鼻空肠管（NJ）组。所有患者均接受 Peptamen AF 作为口服摄入的补充。对患者进行随访，直至出院或死亡。
本研究评估了 33 例患者在插入管饲后 7 天的数据。7 天内的平均每日能量摄入量为 6509kJ（NG）与 6605kJ（NJ）（=0.90）。患者意外拔出管饲的次数：1 次（16%）；2 次（9%）；3 次（6%），NG 组与 NJ 组之间无差异。
在插入管饲后 7 天，早期 NG 喂养与早期 NJ 喂养之间总营养摄入量无显著差异。两组更换管饲的次数相似。严重肝病患者管饲的选择将取决于患者的个体特征和需求以及当地设施。
