Early Enteral Nutrition for Upper Digestive Tract Malformation in Neonates

早期肠内营养在新生儿上消化道梗阻中的应用

Wei-Wei Jiang ； Xiao-Feng Lv ； Xiao-Qun Xu ； Qi-Ming Geng ； Jie Zhang ； Wei-Bing Tang

《Asia Pacific Journal of Clinical Nutrition》 24卷1期 (2015/03) Pp. 38-43

https://doi.org/10.6133/apjcn.2015.24.1.08

摘要

背景：已有的研究证明早期肠内营养优于完全肠外营养。我们的研究目的是探讨早期肠内营养（采用空肠营养管的方法）在新生儿十二指肠或空肠梗阻术后使用的安全性和可行性。方法：我们回顾性研究本院120例十二指肠或空肠梗阻的病人。这些病人被分为两组，早期肠内营养组（70例），完全肠外营养组即对照组（50例）。我们比较两组的手术时间、术后经口喂养达到40mL/3 h的时间、术后住院时间、并发症如导管堵塞、腹泻等及术后营养指标。结果：手术时间和术后首次排便时间两组间没有显著性差异。经口喂养达到40 mL/3 h的时间和术后住院时间肠内营养组均明显短于完全肠外营养组。术后14天时总蛋白、前白蛋白及视黄醇结合蛋白肠内营养组明显高于完全肠外营养组。胆汁淤积的发生率肠内营养组明显低于完全肠外营养组。腹泻发生率肠内营养组低于完全肠外营养组，但无统计学意义。结论：采用空肠营养管的早期肠内营养方法在新生儿上消化道梗阻术后使用是可行的，并且并发症较少。

關鍵字

空肠营养管 ； 肠内营养 ； 十二指肠或空肠先天性梗阻 ； 新生儿

並列摘要

Background: Early enteral nutrition (EEN) is better than total parenteral nutrition (TPN) for many reasons. Our aim was to determine the safety and feasibility of EEN using a jejunum feeding tube in the duodenum or jejunum for congenital obstruction in neonates post-operatively. Methods: This was a retrospective review of 120 patients who had duodenal and jejunal congenital obstructions in our hospital. The patients were categorized into two groups (EEN group [n=70 patients] and control group [n=50 patients]). Differences in operative time, postoperative time to tolerate oral feeding (40 mL/3 h), post-operative hospital stay, and complications, such as catheter obstruction, diarrhea, and nutrition index, were reviewed. Results: The operative time and time to first defecation post-operatively was not significantly different between the two groups. The time to tolerate oral feeding (40 mL/3 h) and the hospital length of stay post-operatively for the EEN group were significantly shorter than the control group. Total protein, pre-albumin, and retinol binding protein were significantly higher in the EEN group than the control group 14 days post-operatively. The incidence of cholestasis and obstruction in the EEN group was significantly lower than the control group, and the incidence of diarrhea was lower than the control group, but not significantly lower. Conclusion: EEN using a jejunal feeding tube in an upper digestive tract malformation in newborns post-operatively is safe, easy, and has fewer complications.

並列關鍵字

jejunum nutrition tube ； enteral nutrition ； duodenum or jejunum congenital obstruction ； neonate