极低出生体重儿聚乙烯饲管的使用和医源性咽-食管穿孔  

Use of polyvinyl feeding tubes and iatrogenic pharyngo-oesophageal perforation in very-low-birthweight infants

作　　者：Filippi L. Pezzati M. Poggi C. 朱新菊 

机构地区：[1]Neonatal Intensive Care Unit, Department of Critical Care Medicine, University Careggi Hospital, viale Morgagni, 85, I-50134 Florence, Italy

出　　处：《世界核心医学期刊文摘（儿科学分册）》2006年第6期9-10,共2页

摘　　要：Abstract Abstract Background: Placement of a feeding tube may be associated with various complications, including iatrogenic pharyngooesophageal perforation. Aim: To determine the incidence of pharyngo-oesophageal perforation secondary to the use of polyvinyl feeding tubes in newborns weighing less than 1500 g, we conducted a retrospective study over a 3 12-y period. Methods: All the hospital files of the 371 very-low-birthweight newborns admitted were retrospectively reviewed. Results: Three iatrogenic pharyngo-oesophageal perforations were observed, giving an incidence of 1 : 124 preterm infants. This incidence reaches values of 1 : 25 newborns weighing less than 750 g. Data from our cases included clinical presentation and outcome, radiological evaluation, and type of feeding tube. One infant died of sepsis, and the clinical course was compatible with mediastinitis. The other two infants were treated successfully with conservative non-surgical management. Conclusion: Pharyngo-oesophageal perforation in our experience exclusively involved preterm infants weighing less than 750 g after traumatic placement of a polyvinyl feeding tube. The use of a silastic feeding tube with a really soft end instead of polyvinyl catheters could probably avoid iatrogenic oesophageal perforation.Background： Placement of a feeding tube may be associated with various complications, including iatrogenic pharyngooesophageal perforation. Aim： To determine the incidence of pharyngo-oesophageal perforation secondary to the use of polyvinyl feeding tubes in newborns weighing less than 1500 g, we conducted a retrospective study over a 3 1/2-y period. Methods： All the hospital files of the 371 very-low-birthweight newbems admitted were retrospectively reviewed. Results： Three iatrogenic pharyngo-oesophageal perforations were observed, giving an incidence of 1 ： 124 preterm infants. This incidence reaches values of 1 ： 25 newborns weighing less than 750 g. Data from our cases included clinical presentation and outcome, radiological evaluation, and type of feeding tube. One infant died of sepsis, and the clinical course was compatible with mediastinitis. The other two infants were treated successfully with conservative non-surgical management. Conclusion： Pharyngo-oesophageal perforation in our experience exclusively involved preterm infants weighing less than 750 g after traumatic placement of a polyvinyl feeding tube.

关 键 词：医源性食管穿孔 极低出生体重儿 聚乙烯 咽 回顾性调查 早产婴儿 影像学检查 发生率 临床表现 临床过程 

分 类 号：R655.4[医药卫生—外科学] R722[医药卫生—临床医学]