Collier P, Kudsk K A, Glezer J, Brown R O
Nutr Clin Pract. 1994 Jun;9(3):101-3. doi: 10.1177/0115426594009003101.
Despite the high frequency of diarrhea, chemically defined diets have traditionally been used with needle catheter jejunostomies, a common form of postpyloric enteral access, to avoid tube occlusion. We reviewed our experience with 57 patients fed a fiber-containing diet to determine the incidence of catheter occlusion and diarrhea. Eight catheters temporarily occluded but were reopened and remained patent for an additional 6.3 +/- 3.1 days for an overall success rate of 91% (52 of 57). The five remaining occluded catheters were removed after 6.2 +/- 1.8 days. Four of the five patients with occluded catheters tolerated gastric feedings, but one required a permanent jejunostomy. Diarrhea occurred in six (10.5%) of the 57 patients given the fiber-containing formula. We concluded that a fiber-containing formula can be administered through needle catheter jejunostomies if the catheter is irrigated daily and if no medications are given via the catheter. A fiber-containing formula may reduce the incidence of diarrhea in jejunostomy-fed patients compared with patients fed chemically defined diets.
尽管腹泻发生率较高,但传统上化学限定饮食一直与针导管空肠造口术(一种常见的幽门后肠内营养通路形式)一起使用,以避免导管堵塞。我们回顾了57例接受含纤维饮食喂养患者的经验,以确定导管堵塞和腹泻的发生率。8根导管暂时堵塞,但重新开通后又保持通畅6.3±3.1天,总体成功率为91%(57例中的52例)。其余5根堵塞的导管在6.2±1.8天后被拔除。5例导管堵塞患者中有4例能够耐受胃内喂养,但有1例需要永久性空肠造口术。在接受含纤维配方饮食的57例患者中,有6例(10.5%)发生腹泻。我们得出结论,如果每天冲洗导管且不通过导管给药,含纤维配方饮食可以通过针导管空肠造口术给药。与接受化学限定饮食的患者相比,含纤维配方饮食可能会降低空肠造口术喂养患者的腹泻发生率。