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创伤患者经针导管空肠造口术的并发症及长期预后分析

Analysis of complications and long-term outcome of trauma patients with needle catheter jejunostomy.

作者信息

Eddy V A, Snell J E, Morris J A

机构信息

Department of Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.

出版信息

Am Surg. 1996 Jan;62(1):40-4.

PMID:8540644
Abstract

Enteral feedings demonstrably lower the risk of septic complications. However, complications associated with the specific method of enteral feeding may diminish the intended benefits. The objective was to determine the short and long-term complications associated with needle catheter jejunostomy (NCJ). All NCJs placed at a Level I trauma center over an 8-year period were reviewed. Short-term complications directly attributable to NCJ were defined as tube leakage with intraabdominal or intraparietal spillage, intraabdominal abscess, small bowel obstruction at the catheter site, tube blockage or dislodgement, or soft tissue infection. Telephone interviews were conducted to elicit long-term complications, including operations to correct a complication of the NCJ, chronic nausea, vomiting, diarrhea, bloating, hernia, or change in appetite. Of 122 study patients, short-term complications (N = 22) included two abscesses, one bowel obstruction, two abdominal wall infections, three leaks, one local soft tissue infection, one enterocutaneous fistula, three blocked catheters, and nine tube dislodgements. Fifty patients were contacted by telephone; 19 had long-term complications, including two operations for adhesions. Complications associated with NCJ are common, may be life-threatening, and may require surgical intervention. In many cases, other methods of enteral feeding access may be preferable to NCJ.

摘要

肠内喂养可显著降低感染并发症的风险。然而,与特定肠内喂养方法相关的并发症可能会削弱预期的益处。目的是确定与针导管空肠造口术(NCJ)相关的短期和长期并发症。回顾了在一级创伤中心8年期间放置的所有NCJ。直接归因于NCJ的短期并发症定义为管漏伴腹腔内或腹壁内渗漏、腹腔内脓肿、导管部位小肠梗阻、管堵塞或移位,或软组织感染。通过电话访谈了解长期并发症,包括纠正NCJ并发症的手术、慢性恶心、呕吐、腹泻、腹胀、疝气或食欲改变。在122例研究患者中,短期并发症(N = 22)包括2例脓肿、1例肠梗阻、2例腹壁感染、3例渗漏、1例局部软组织感染、1例肠皮肤瘘、3例导管堵塞和9例管移位。通过电话联系了50例患者;19例有长期并发症,包括2例因粘连进行的手术。与NCJ相关的并发症很常见,可能危及生命,可能需要手术干预。在许多情况下,其他肠内喂养途径可能比NCJ更可取。

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