Objective: To systematically evaluate the effects of heating infusion on gastrointestinal complications of patients with enteral nutrition. Methods: The domestic and foreign databases including Cochrane Library, PubMe...Objective: To systematically evaluate the effects of heating infusion on gastrointestinal complications of patients with enteral nutrition. Methods: The domestic and foreign databases including Cochrane Library, PubMed, EMBASE, Web of Science, Chinese biomedical literature database (CBM), Wan Fang database (Wan Fang), China National Knowledge Infrastructure (CNKI) and VIP Database for Chinese Technical Periodicals(VIP) were retrieved. The retrieval contents were randomized controlled trials on improving gastrointestinal complications of patients with enteral nutrition by heating infusion of nutrient solution. Data were collected by two reviewers according to the data extraction tables. Results: A total of 17 randomized controlled trials with 1683 subjects were chosen. The results of meta analysis showed that the rate of abdominal pain, abdominal distension and nausea in patients with enteral nutrition could be reduced by warm infusion of nutrient solution, but the effect of the infusion on vomiting, constipation, stomach retention and diarrhea was not superior. Conclusion: Heating infusion of nutrient solution can reduce the incidence of abdominal pain, abdominal distension and nausea in patients with enteral nutrition.展开更多
Some controversy surrounds the postoperative feeding regimen utilized in patients who undergo esophagectomy.Variation in practices during the perioperative period exists including the type of nutrition started,the del...Some controversy surrounds the postoperative feeding regimen utilized in patients who undergo esophagectomy.Variation in practices during the perioperative period exists including the type of nutrition started,the delivery route,and its timing.Adequate nutrition is essential for this patient population as these patients often present with weight loss and have altered eating patterns after surgery,which can affect their ability to regain or maintain weight.Methods of feeding after an esophagectomy include total parenteral nutrition,nasoduodenal/nasojejunal tube feeding,jejunostomy tube feeding,and oral feeding.Recent evidence suggests that early oral feeding is associated with shorter LOS,faster return of bowel function,and improved quality of life.Enhanced recovery pathways after surgery pathways after esophagectomy with a component of early oral feeding also seem to be safe,feasible,and cost-effective,albeit with limited data.However,data on anastomotic leaks is mixed,and some studies suggest that the incidence of leaks may be higher with early oral feeding.This risk of anastomotic leak with early feeding may be heavily modulated by surgical approach.No definitive data is currently available to definitively answer this question,and further studies should look at how these early feeding regimens vary by surgical technique.This review aims to discuss the existing literature on the optimal route and timing of feeding after esophagectomy.展开更多
AIM: To investigate whether single endoscopist-performed percutaneous endoscopic gastrostomy (PEG) is safe and to compare the complications of PEG with those reported in the literature. METHODS: Patients who underwent...AIM: To investigate whether single endoscopist-performed percutaneous endoscopic gastrostomy (PEG) is safe and to compare the complications of PEG with those reported in the literature. METHODS: Patients who underwent PEG placement between June 2001 and August 2011 at the Baskent University Alanya Teaching and Research Center were evaluated retrospectively. Patients whose PEG was placed for the first time by a single endoscopist were enrolled in the study. PEG was performed using the pull method. All of the patients were evaluated for their indications for PEG, major and minor complications resulting from PEG, nutritional status, C-reactive protein (CRP) levels and the use of antibiotic treatment or antibiotic prophylaxis prior to PEG. Comorbidities, rates, time and reasons for mortality were also evaluated. The reasons for PEG removal and PEG duration were also investigated. RESULTS: Sixty-two patients underwent the PEG procedure for the first time during this study. Eight patients who underwent PEG placement by 2 endoscopists were not enrolled in the study. A total of 54 patients were investigated. The patients' mean age was 69.9 years. The most common indication for PEG was cerebral infarct, which occurred in approximately two-thirds of the patients. The mean albumin level was 3.04 ± 0.7 g/dL, and 76.2% of the patients' albumin levels were below the normal values. The mean CRP level was high in 90.6% of patients prior to the procedure. Approximately two-thirds of the patients received antibiotics for either prophylaxis or treatment for infections prior to the PEG procedure. Mortality was not related to the procedure in any of the patients. Buried bumper syndrome was the only major complication, and it occurred in the third year. In such case, the PEG was removed and a new PEG tube was placed via surgery. Eight patients (15.1%) experienced minor complications, 6 (11.1%) of which were wound infections. All wound infections except one recovered with antibiotic treatment. Two patients had bleeding from the PEG site, one was resolved with primary suturing and the other with fresh frozen plasma transfusion. CONCLUSION: The incidence of major and minor complications is in keeping with literature. This finding may be noteworthy, especially in developing countries.展开更多
目的观察鼻肠管、鼻胃管肠内营养对重型颅脑损伤患者营养状态、并发症及预后影响。方法将2018年1月—2021年5月收治的68例重型颅脑损伤患者按治疗方式分为观察组、对照组,每组34例,观察组留置鼻肠管行肠内营养治疗,对照组留置鼻胃管行...目的观察鼻肠管、鼻胃管肠内营养对重型颅脑损伤患者营养状态、并发症及预后影响。方法将2018年1月—2021年5月收治的68例重型颅脑损伤患者按治疗方式分为观察组、对照组,每组34例,观察组留置鼻肠管行肠内营养治疗,对照组留置鼻胃管行肠内营养治疗,治疗14 d后,分析2组患者营养指标(血红蛋白、血清总蛋白、血清白蛋白)变化,统计肠内营养相关并发症发生率,采用格拉斯哥昏迷评分(glasgow coma scale,GCS)、急性生理和慢性健康状况(acute physiology and chronic health evaluation,APACHEⅡ)评分评估患者病情和预后。结果治疗14 d后,观察组血红蛋白、血清总蛋白、血清白蛋白水平均明显高于对照组(P<0.05);治疗期间,观察组肠内营养相关并发症总发生率17.65%,明显低于对照组的41.18%(P<0.05);治疗14 d后,观察组GCS评分明显高于对照组(P<0.05)、APACHEⅡ评分明显低于对照组(P<0.05)。结论相比鼻胃管留置,采取鼻肠管留置下肠内营养在改善重型颅脑损伤患者营养状态、并发症风险及预后方面应用价值更高。展开更多
文摘Objective: To systematically evaluate the effects of heating infusion on gastrointestinal complications of patients with enteral nutrition. Methods: The domestic and foreign databases including Cochrane Library, PubMed, EMBASE, Web of Science, Chinese biomedical literature database (CBM), Wan Fang database (Wan Fang), China National Knowledge Infrastructure (CNKI) and VIP Database for Chinese Technical Periodicals(VIP) were retrieved. The retrieval contents were randomized controlled trials on improving gastrointestinal complications of patients with enteral nutrition by heating infusion of nutrient solution. Data were collected by two reviewers according to the data extraction tables. Results: A total of 17 randomized controlled trials with 1683 subjects were chosen. The results of meta analysis showed that the rate of abdominal pain, abdominal distension and nausea in patients with enteral nutrition could be reduced by warm infusion of nutrient solution, but the effect of the infusion on vomiting, constipation, stomach retention and diarrhea was not superior. Conclusion: Heating infusion of nutrient solution can reduce the incidence of abdominal pain, abdominal distension and nausea in patients with enteral nutrition.
文摘Some controversy surrounds the postoperative feeding regimen utilized in patients who undergo esophagectomy.Variation in practices during the perioperative period exists including the type of nutrition started,the delivery route,and its timing.Adequate nutrition is essential for this patient population as these patients often present with weight loss and have altered eating patterns after surgery,which can affect their ability to regain or maintain weight.Methods of feeding after an esophagectomy include total parenteral nutrition,nasoduodenal/nasojejunal tube feeding,jejunostomy tube feeding,and oral feeding.Recent evidence suggests that early oral feeding is associated with shorter LOS,faster return of bowel function,and improved quality of life.Enhanced recovery pathways after surgery pathways after esophagectomy with a component of early oral feeding also seem to be safe,feasible,and cost-effective,albeit with limited data.However,data on anastomotic leaks is mixed,and some studies suggest that the incidence of leaks may be higher with early oral feeding.This risk of anastomotic leak with early feeding may be heavily modulated by surgical approach.No definitive data is currently available to definitively answer this question,and further studies should look at how these early feeding regimens vary by surgical technique.This review aims to discuss the existing literature on the optimal route and timing of feeding after esophagectomy.
文摘AIM: To investigate whether single endoscopist-performed percutaneous endoscopic gastrostomy (PEG) is safe and to compare the complications of PEG with those reported in the literature. METHODS: Patients who underwent PEG placement between June 2001 and August 2011 at the Baskent University Alanya Teaching and Research Center were evaluated retrospectively. Patients whose PEG was placed for the first time by a single endoscopist were enrolled in the study. PEG was performed using the pull method. All of the patients were evaluated for their indications for PEG, major and minor complications resulting from PEG, nutritional status, C-reactive protein (CRP) levels and the use of antibiotic treatment or antibiotic prophylaxis prior to PEG. Comorbidities, rates, time and reasons for mortality were also evaluated. The reasons for PEG removal and PEG duration were also investigated. RESULTS: Sixty-two patients underwent the PEG procedure for the first time during this study. Eight patients who underwent PEG placement by 2 endoscopists were not enrolled in the study. A total of 54 patients were investigated. The patients' mean age was 69.9 years. The most common indication for PEG was cerebral infarct, which occurred in approximately two-thirds of the patients. The mean albumin level was 3.04 ± 0.7 g/dL, and 76.2% of the patients' albumin levels were below the normal values. The mean CRP level was high in 90.6% of patients prior to the procedure. Approximately two-thirds of the patients received antibiotics for either prophylaxis or treatment for infections prior to the PEG procedure. Mortality was not related to the procedure in any of the patients. Buried bumper syndrome was the only major complication, and it occurred in the third year. In such case, the PEG was removed and a new PEG tube was placed via surgery. Eight patients (15.1%) experienced minor complications, 6 (11.1%) of which were wound infections. All wound infections except one recovered with antibiotic treatment. Two patients had bleeding from the PEG site, one was resolved with primary suturing and the other with fresh frozen plasma transfusion. CONCLUSION: The incidence of major and minor complications is in keeping with literature. This finding may be noteworthy, especially in developing countries.
文摘目的观察鼻肠管、鼻胃管肠内营养对重型颅脑损伤患者营养状态、并发症及预后影响。方法将2018年1月—2021年5月收治的68例重型颅脑损伤患者按治疗方式分为观察组、对照组,每组34例,观察组留置鼻肠管行肠内营养治疗,对照组留置鼻胃管行肠内营养治疗,治疗14 d后,分析2组患者营养指标(血红蛋白、血清总蛋白、血清白蛋白)变化,统计肠内营养相关并发症发生率,采用格拉斯哥昏迷评分(glasgow coma scale,GCS)、急性生理和慢性健康状况(acute physiology and chronic health evaluation,APACHEⅡ)评分评估患者病情和预后。结果治疗14 d后,观察组血红蛋白、血清总蛋白、血清白蛋白水平均明显高于对照组(P<0.05);治疗期间,观察组肠内营养相关并发症总发生率17.65%,明显低于对照组的41.18%(P<0.05);治疗14 d后,观察组GCS评分明显高于对照组(P<0.05)、APACHEⅡ评分明显低于对照组(P<0.05)。结论相比鼻胃管留置,采取鼻肠管留置下肠内营养在改善重型颅脑损伤患者营养状态、并发症风险及预后方面应用价值更高。
