Meguid M M, Eldar S, Wahba A
Cancer. 1985 Jan 1;55(1 Suppl):279-89. doi: 10.1002/1097-0142(19850101)55:1+<279::aid-cncr2820551313>3.0.co;2-t.
With continued interest and increasing awareness of nutritional support to patients, both hospitalized and at home, many new developments in the field of devices and methods of delivering nutritional support have occurred. The indications, methods of use, and the associated complications related to feeding via nasogastric tube, tube esophagostomy, gastrostomy, and jejunostomy in the light of new devices and methods are outlined. The authors' experience shows that postoperative enteral feeding is a reliable and efficient method of providing supportive nutrition, provided the appropriate patients are selected. Home enteral nutritional support via gastrostomy allows stable cancer patients to maintain their nutritional status and enjoy life independent of the hospital setting for an extended period of time. When feeding via the gastrointestinal tract is neither feasible nor desirable, for both short-term and long-term nutritional support, access to the central venous system becomes necessary because peripheral vein feeding has limited cost-effectiveness. Delivery of nutrients into the superior vena cava by long antecubital catheters has been advocated, and the use of Hickman/Broviac catheters, instead of conventional subclavian catheters, is becoming an increasingly common practice. Experience with the use of arteriovenous fistulae and the Infuse-A-Port (Infusaid Corp.) are reviewed; the method used for declotting infected and thrombosed catheters is outlined. Current trends in the use of three-liter bags containing a fat emulsion with glucose and amino acids are mentioned.
随着对住院患者和居家患者营养支持的持续关注以及认识的不断提高，营养支持设备和方法领域出现了许多新进展。根据新设备和新方法，概述了经鼻胃管、食管造瘘管、胃造瘘术和空肠造瘘术喂养的适应证、使用方法及相关并发症。作者的经验表明，只要选择合适的患者，术后肠内喂养是提供支持性营养的可靠且有效的方法。通过胃造瘘术进行家庭肠内营养支持可使病情稳定的癌症患者维持营养状况，并在较长时间内无需住院就能享受生活。当经胃肠道喂养既不可行也不理想时，无论是短期还是长期营养支持，由于外周静脉喂养的成本效益有限，就需要建立中心静脉通路。有人主张通过较长的肘前静脉导管将营养物质输送至上腔静脉，使用Hickman/Broviac导管而非传统的锁骨下导管正变得越来越普遍。本文回顾了动静脉瘘和植入式输液港（Infusaid公司）的使用经验；概述了处理感染和血栓形成导管的溶栓方法。文中还提到了使用含脂肪乳剂、葡萄糖和氨基酸的三升袋的当前趋势。
