Delany H M
Department of Surgery, Albert Einstein College of Medicine, Bronx Municipal Hospital Center, NY 10461.
J Assoc Acad Minor Phys. 1993;4(1):26-9.
Access to the jejunum by orogastric intubation or insertion of a surgical tube provides a method for nutrient infusion in clinical conditions that involve abnormal upper gastrointestinal function. Despite the physiologically extraordinary nature of jejunostomy intubation-with enteral infusions beyond the stomach, biliary tract, pancreas, and duodenum--the current view is that jejunal feeding is an acceptable alternative to parenteral nutritional support. Because jejunostomies utilize the gastrointestinal tract, administering feedings by this route can minimize some of the major adverse effects of total intravenous nutrition. The problems with jejunal intubation relate to the technical difficulty of the procedure itself, indications for its general use, and its adaptation as an adjunct in the management of the surgical patient. The timing, composition, and metabolic effects of jejunal nutrient infusions are the subject of continuing debate and study.
经口胃插管或插入手术管进入空肠，为涉及上消化道功能异常的临床情况提供了一种营养输注方法。尽管空肠造口插管在生理上具有特殊性——肠内输注绕过胃、胆道、胰腺和十二指肠——但目前的观点认为，空肠喂养是肠外营养支持的一种可接受的替代方法。由于空肠造口利用了胃肠道，通过这种途径给予喂养可以将全静脉营养的一些主要不良反应降至最低。空肠插管的问题涉及该操作本身的技术难度、其普遍使用的适应症以及作为手术患者管理辅助手段的适应性。空肠营养输注的时机、成分和代谢效应仍是持续争论和研究的主题。
