小儿消化道手术时经皮穿刺造口置管早期肠内营养支持  

Early Jejunostomy Tube Feeding in Children After Major Abdominal Surgery

作　　者：黄娟[1] 蔡威[1] 汤庆娅[1] 王俊[2] 施诚仁[2] 

机构地区：[1]上海交通大学医学院新华医院临床营养中心,上海200092 [2]上海交通大学医学院新华医院小儿外科,上海200092

出　　处：《上海交通大学学报（医学版）》2006年第11期1206-1208,共3页Journal of Shanghai Jiao tong University:Medical Science

基　　金："十五"国家科技攻关计划基金(2004BA709B09)资助项目

摘　　要：目的 评估儿科患者胃肠手术时经皮空肠穿刺造口置管早期空肠营养的安全性和有效性。方法 分析我院小儿外科2000年1月～2005年12月，消化道手术中经皮空肠穿刺造瘘加术后空肠造瘘管喂养患儿14例，其中新生儿9例。观察经空肠喂养患儿的肠道耐受性、置管天数、体质量增长及相关并发症的发生情况。结果 14例患儿中12例治愈，1例死亡，1例因经济原因自动出院。空肠营养期间新生儿体质量增长平均为18．9g／d。14例中4例发生相关并发症。结论 经皮空肠穿刺造口置管可长时间、正常及合理应用，且并发症少，为消化道手术后儿科早期肠内营养提供了一个安全可行的途径。Objective To evaluate the feasibility, safety and nutrition outcome of early enteral feeding via a jejunostomy tube in children after major abdominal surgery. Methods From January 2000 to December 2005, needle catheter jejunostomy was performed on 14 patients at the time of abdominal surgery, nine of whom were neonates. Enteral nutrition was initiated as early as possible after surgery by feeding small amount of standard diet. Patient tolerance was carefully monitored. Patients were also fed parenterally in order to achieve targeted caloric goals whenever necessary. Medical records of consenting patients were abstracted for demographics, indication, complications and weight gain. Results Of all the 14 patients, 12 were cured. The only death was due to severe premature and complicated clinical situations. One patient discharged against advice. No major tube- or feeding-related complications were observed. Minor complications were found in four cases. An average weight gain of 18.9 g/d was achieved in nine neonates. Conclusion In patients with major abdominal surgery, needle catheter jejunostomy offers a safe way for early enteral nutrition with no additional risk.

关 键 词：经皮空肠穿刺造口置管 肠内营养 腹部手术 儿童 

分 类 号：R726.5[医药卫生—儿科]