Hsu J J, Clark-Glena R, Nelson D K, Kim C H
Isaac Gordon Center for Digestive Diseases and Nutrition, Genesee Hospital, Rochester, New York, USA.
Obstet Gynecol. 1996 Sep;88(3):343-6. doi: 10.1016/0029-7844(96)00174-3.
To report our experience in treating hyperemesis gravidarum with nasogastric enteral feeding.
Seven women (ages 17-36 years, mean 27 years) presented with intractable nausea, vomiting, dehydration, and weight loss (mean 13 lb) and were hospitalized for management of symptoms and nutritional support. An 8-Fr Dobbhoff nasogastric feeding tube was placed and nutritional supplement was administered as a continuous infusion, starting at a rate of 25 mL/hour. The rate of infusion was increased in an incremental fashion until daily caloric requirements were met.
Nausea and vomiting improved within 24 hours after nasogastric tube placement. Enteral feedings were well tolerated, and all patients were discharged from the hospital within 8 days. Enteral feedings were continued, in an outpatient setting, for a mean of 43 days (range 5-174). Ultimately, all patients resumed oral feeding and discontinued enteral feeding. Subsequently, all patients gave birth to full-term, normal-weight babies.
Enteral feeding via nasogastric tube seems to be effective in relieving intractable nausea and vomiting and in providing adequate nutritional support. Enteral nutrition should be considered as an alternative to total parenteral nutrition in the management of hyperemesis gravidarum.
报告我们使用鼻胃管肠内喂养治疗妊娠剧吐的经验。
7名女性（年龄17 - 36岁，平均27岁）出现顽固性恶心、呕吐、脱水和体重减轻（平均减轻13磅），因症状管理和营养支持而住院。放置一根8Fr的多布霍夫鼻胃饲管，并以25毫升/小时的速度开始持续输注营养补充剂。输注速度逐步增加，直至满足每日热量需求。
放置鼻胃管后24小时内恶心和呕吐症状改善。肠内喂养耐受性良好，所有患者均在8天内出院。在门诊环境中继续进行肠内喂养，平均持续43天（范围为5 - 174天）。最终，所有患者恢复经口喂养并停止肠内喂养。随后，所有患者均分娩出足月、体重正常的婴儿。
通过鼻胃管进行肠内喂养似乎对缓解顽固性恶心和呕吐以及提供充足的营养支持有效。在妊娠剧吐的管理中，肠内营养应被视为全胃肠外营养的替代方法。
