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经皮内镜胃造瘘术后早期管饲:一项观察性研究。

Early Tube Feeding after Percutaneous Endoscopic Gastrostomy (PEG): An Observational Study.

机构信息

Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern University Hospital Inselspital and University of Bern, 3010 Bern, Switzerland.

Academic-Practice-Partnership of Bern University of Applied Sciences and Insel Gruppe (Bern University Hospital Inselspital), 3008 Bern, Switzerland.

出版信息

Nutrients. 2023 Feb 25;15(5):1157. doi: 10.3390/nu15051157.

Abstract

This study investigated whether enteral nutrition by early tube feeding led to changes in clinical parameters compared to tube feeding after 24 h. Starting on 1 January 2021, and following the latest update of the ESPEN guidelines on enteral nutrition, patients with percutaneous endoscopic gastrostomy (PEG) received tube feeding 4 h after tube insertion. An observational study was conducted to analyze whether the new scheme affected patient complaints, complications, or hospitalization duration compared to the previous procedure of tube feeding starting after 24 h. Clinical patient records from one year before and one year after the introduction of the new scheme were examined. A total of 98 patients were included, and of those 47 received tube feeding 24 h after tube insertion, and 51 received tube feeding 4 h after tube insertion. The new scheme did not influence the frequency or severity of patient complaints or complications related to tube feeding (all -values > 0.05). However, the study showed that the length of stay in hospital was significantly shorter when following the new scheme ( = 0.030). In this observational cohort study an earlier start of tube feeding did not produce any negative consequences but did reduce the duration of hospitalization. Therefore, an early start, as suggested in the recent ESPEN guidelines, is supported and recommended.

摘要

本研究旨在探讨与 24 小时后进行肠内营养相比,早期管饲肠内营养是否会导致临床参数发生变化。自 2021 年 1 月 1 日起,根据 ESPEN 肠内营养指南的最新更新,接受经皮内镜胃造口术(PEG)的患者在插入管后 4 小时内进行管饲。进行了一项观察性研究,以分析与之前 24 小时后开始管饲的程序相比,新方案是否会影响患者的抱怨、并发症或住院时间。检查了新方案引入前一年和引入后一年的临床患者记录。共纳入 98 例患者,其中 47 例在插入管后 24 小时内进行管饲,51 例在插入管后 4 小时内进行管饲。新方案并未影响与管饲相关的患者抱怨或并发症的频率或严重程度(所有 - 值 > 0.05)。然而,研究表明,遵循新方案时住院时间明显缩短( = 0.030)。在这项观察性队列研究中,早期开始管饲并没有产生任何不良后果,但确实缩短了住院时间。因此,支持并推荐早期开始管饲,正如最近的 ESPEN 指南所建议的那样。

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ESPEN guideline on home enteral nutrition.ESPEN 指南:家庭肠内营养。
Clin Nutr. 2020 Jan;39(1):5-22. doi: 10.1016/j.clnu.2019.04.022. Epub 2019 May 30.
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ESPEN guidelines on nutrition in cancer patients.ESPEN 肿瘤患者营养指南。
Clin Nutr. 2017 Feb;36(1):11-48. doi: 10.1016/j.clnu.2016.07.015. Epub 2016 Aug 6.
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Enteral access in adults.成人的肠内通路
Clin Nutr. 2015 Jun;34(3):350-8. doi: 10.1016/j.clnu.2014.10.009. Epub 2014 Nov 13.

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