Jensen G L, Sporay G, Whitmire S, Taraszewski R, Reed M J
Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, Pennsylvania 17822, USA.
JPEN J Parenter Enteral Nutr. 1995 May-Jun;19(3):244-7. doi: 10.1177/0148607195019003244.
The provision of early postoperative enteral feeding may be enhanced by the placement of enteral feeding access during celiotomy, but surgeons are often reluctant to pursue this option because of the extra effort required.
We conducted a retrospective review of our 2-year experience with 60 sequential intraoperative nasoenteric feeding-tube placements and included data on demographics, diagnosis, surgery, type of feeding tube, formula, tolerance, and complications. Our surgeons placed intraoperative nasoenteric feeding tubes at their discretion in a variety of subjects who were undergoing elective or urgent celiotomies.
The surgeries largely involved the upper gastrointestinal tract, and feeding-tube placements were readily accomplished. The majority of patients received enteral feedings within 3 postoperative days and achieved feeding rates of 50 mL/h or greater. The average duration of feeding-tube use was 1 week, accounting for 399 feeding days overall. There were no serious complications attributable to feeding-tube placement or use, but inadvertent tube removal by patients or staff was a limitation.
Intraoperative placement of the nasoenteric feeding tube may be a reasonable option for treating the surgical patient at nutritional risk who faces a limited course of impaired oral intake postoperatively.
剖腹术期间放置肠内营养通路可促进术后早期肠内营养的实施，但由于需要额外的操作，外科医生往往不愿采用这种方法。
我们回顾性分析了连续60例术中放置鼻肠喂养管的2年经验，纳入了人口统计学、诊断、手术、喂养管类型、配方奶、耐受性和并发症等数据。我们的外科医生根据自己的判断，在接受择期或急诊剖腹术的各类患者中术中放置鼻肠喂养管。
手术主要涉及上消化道，喂养管放置操作简便。大多数患者在术后3天内开始肠内营养，喂养速度达到或超过50 mL/h。喂养管平均使用时间为1周，总共进行了399天的喂养。未出现因喂养管放置或使用导致的严重并发症，但患者或工作人员意外拔管是一个限制因素。
对于术后面临短期经口摄入受限且存在营养风险的手术患者，术中放置鼻肠喂养管可能是一种合理的选择。
