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Nursing Experience of Early Application of Nasoenteric Tube for Enteral Nutrition in Critically Ill ICU Patients
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作者 Jingjing Xin Jingfei Song Jing Wang 《Journal of Clinical and Nursing Research》 2024年第8期276-282,共7页
Objective:To investigate the effective nursing measures of early application of nasoenteric tube for enteral nutrition in critically ill patients in ICU,and to summarize the nursing experience.Methods:The study was ca... Objective:To investigate the effective nursing measures of early application of nasoenteric tube for enteral nutrition in critically ill patients in ICU,and to summarize the nursing experience.Methods:The study was carried out in June 2023–November 2023.62 samples of ICU critically ill patients were selected,all of whom used enteral nutrition by mesenteric tube and were grouped into an observation group(n=31)and a control group(n=31)by using the numerical table randomization method.The patients in the control group were basic nursing interventions,and the patients in the observation group were comprehensive quality care,comparing the nutritional indexes,complication rates,and nursing satisfaction between the two groups.Results:All nutritional indicators of the observation group were higher than those of the control group after nursing intervention(P<0.05);the complication rate of the observation group was lower than that of the control group(P<0.05);the nursing satisfaction of the observation group was higher than that of the control group(P<0.05).Conclusion:Comprehensive quality nursing care during the early application of a gastroenteric tube for enteral nutrition in critically ill patients in the ICU can improve nutritional indexes,reduce the incidence of complications and improve nursing satisfaction. 展开更多
关键词 ICU critically ill patients Nasoenteric tube Enteral nutrition Nursing care
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EFFECTS OF ENTERAL AND PARENTERAL NUTRITION ON GASTROENTERIC HORMONES AND GASTRIC MOTILITY AFTER SUBTOTAL GASTRECTOMY 被引量:4
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作者 Wei-ming Kang Jian-chun Yu +2 位作者 Qun Zhang Mei-yun Ke Jia-ming Qian 《Chinese Medical Sciences Journal》 CAS CSCD 2008年第2期113-116,共4页
Objective To investigate the effects of enteral nutrition (EN) and parenteral nutrition (PN) on gastric motility and gastroentefic hormones after subtotal gastrectomy. Methods Forty-one patients underwent gastrec... Objective To investigate the effects of enteral nutrition (EN) and parenteral nutrition (PN) on gastric motility and gastroentefic hormones after subtotal gastrectomy. Methods Forty-one patients underwent gastrectomy were randomly divided into EN group (n=20) and PN group (n=21 ). From the first postoperative day to the seventh day, patients received either EN (EN group) or PN (PN group) with isocalofic (84.9kJ·kg^-1·d^-1) and isonitrogenous (0.11g·kg^-1·d^-1) intake. Serum gastrin (GAS), plasma mofilin (MTL), and plasma cholecystokinin (CCK) were measured on preoperative day, the first and seventh postoperative day. Electrogastrography (EGG) was measured on preoperative day and the seventh postoperative day. Results Compared with preoperafion, blood GAS, MTL, and CCK levels of 41 patients decreased significantly on the first day after subtotal gastrectomy ( P 〈 0. 001 ), but returned to the preoperative levels one week later. EGG after gastrectomy showed that gastric basal electrical rhythm was significantly restrained ( P 〈 0. 001 ). On the seventh day after subtotal gastrectomy, plasma MTL and CCK levels in EN group were higher than those in PN group ( P 〈 0.05 ). There was no difference in GAS level between two groups. EGG in EN group was better than that in PN group postoper- atively. Conclusions The levels of gastroentefitic hormones and the gastric motility decrease significantly after subtotal gastrectomy. In contrast with PN, EN can accelerate the recovery of MTL, CCK, and gastric motility after subtotal gastrectomy. 展开更多
关键词 enteral nutrition parenteral nutrition gastroenteric hormones gastric motility GASTRECTOMY
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Risk Factors of Enternal Nutrition Intolerance in Septic Patients:A Case-control Study
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作者 Li-zhu WANG Yan XIANG +4 位作者 Qian LI Yi-rong ZHU Jue FANG Xiao-dan LU Zhao-cai ZHANG 《Current Medical Science》 SCIE CAS 2024年第2期328-332,共5页
Objective:This study aimed to investigate the incidence of enteral nutrition intolerance(ENI)in patients with sepsis and explore potential risk factors.Methods:A case-control study was conducted in patients with sepsi... Objective:This study aimed to investigate the incidence of enteral nutrition intolerance(ENI)in patients with sepsis and explore potential risk factors.Methods:A case-control study was conducted in patients with sepsis who were receiving enteral nutrition(EN)at a tertiary hospital in China.The included patients were divided into the ENI group and the non-ENI group.Univariate and multivariate analyses were performed to identify the risk factors for ENI.Results:A total of 859 patients were included in the study.Among them,288(33.53%)patients experienced symptoms of ENI,including diarrhea,vomiting,bloating,and gastric retention.Logistic regression analysis revealed that the Acute Physiology and Chronic Health Evaluation H(APACHE H)score,thoracocentesis,and usage of cardiotonic drugs(namely,inotropes)were independent predictors of the ENI.Conclusion:The incidence of ENI is relatively high in patients with sepsis,especially in those who have higher APACHE H scores,have undergone thoracocentesis,and have received inotropes. 展开更多
关键词 SEPSIS enteral nutrition intolerance influencing factor
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Relationship between nutritional therapy and beneficial bacteria ratio in severe disease
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作者 Kento Nakayama Hiroyuki Koami Yuichiro Sakamoto 《Journal of Acute Disease》 2024年第1期26-30,共5页
Objective:To evaluate relationship between changes in the beneficial bacteria in intensive care unit(ICU)patients and nutritional therapy type.Methods:Ten patients aged≥18 years admitted to the ICU between January an... Objective:To evaluate relationship between changes in the beneficial bacteria in intensive care unit(ICU)patients and nutritional therapy type.Methods:Ten patients aged≥18 years admitted to the ICU between January and December 2020,were included.Good enteral nutrition was defined as early achievement of target calorie intake through enteral feeding.The ratio of beneficial bacteria at the first and second bowel movements after each patient’s admission was calculated and the patients were classified into the increase or decrease group.Among all patients,five each were in the increase and decrease groups.We investigated patient background,changes in sequential organ failure assessment(SOFA)and acute physiology and chronic health evaluation(APACHE)Ⅱscores,nutritional doses or methods,and clinical outcomes.Results:No relationship was found between changes in the ratio of beneficial bacteria and changes in SOFA/APACHEⅡscores at the time of admission.The rate of good enteral nutrition was significantly higher in the increase group than in the decrease group(4/5 vs.0/5,P=0.01).Conclusions:An increase in beneficial bacteria may be significantly related to the early establishment of enteral nutrition.In the future,accumulating cases may make it possible to establish a new nutritional strategy for critically ill patients from an intestinal microbiota perspective. 展开更多
关键词 Beneficial bacteria Enteral nutrition Parenteral nutrition Intensive care unit Good enteral nutrition Severe disease nutritional therapy
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Prediction model establishment and validation for enteral nutrition aspiration during hospitalization in patients with acute pancreatitis
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作者 Ping Hou Hao-Jun Wu +4 位作者 Tang Li Jia-Bin Liu Quan-Qing Zhao Hong-Jiang Zhao Zi-Ming Liu 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第8期2583-2591,共9页
BACKGROUND Acute pancreatitis(AP)is a disease caused by abnormal activation of pancreatic enzymes and can lead to self-digestion of pancreatic tissues and dysfunction of other organs.Enteral nutrition plays a vital ro... BACKGROUND Acute pancreatitis(AP)is a disease caused by abnormal activation of pancreatic enzymes and can lead to self-digestion of pancreatic tissues and dysfunction of other organs.Enteral nutrition plays a vital role in the treatment of AP because it can meet the nutritional needs of patients,promote the recovery of intestinal function,and maintain the barrier and immune functions of the intestine.However,the risk of aspiration during enteral nutrition is high;once aspiration occurs,it may cause serious complications,such as aspiration pneumonia,and suffocation,posing a threat to the patient’s life.This study aims to establish and validate a prediction model for enteral nutrition aspiration during hospitalization in patients with AP.AIM To establish and validate a predictive model for enteral nutrition aspiration during hospitalization in patients with AP.METHODS A retrospective review was conducted on 200 patients with AP admitted to Chengdu Shangjin Nanfu Hospital,West China Hospital of Sichuan University from January 2020 to February 2024.Clinical data were collected from the electronic medical record system.Patients were randomly divided into a validation group(n=40)and a modeling group(n=160)in a 1:4 ratio,matched with 200 patients from the same time period.The modeling group was further categorized into an aspiration group(n=25)and a non-aspiration group(n=175)based on the occurrence of enteral nutrition aspiration during hospitalization.Univariate and multivariate logistic regression analyses were performed to identify factors influencing enteral nutrition aspiration in patients with AP during hospitalization.A prediction model for enteral nutrition aspiration during hospitalization was constructed,and calibration curves were used for validation.Receiver operating characteristic curve analysis was conducted to evaluate the predictive value of the model.RESULTS There was no statistically significant difference in general data between the validation and modeling groups(P>0.05).The comparison of age,gender,body mass index,smoking history,hypertension history,and diabetes history showed no statistically significant difference between the two groups(P>0.05).However,patient position,consciousness status,nutritional risk,Acute Physiology and Chronic Health Evaluation(APACHE-II)score,and length of nasogastric tube placement showed statistically significant differences(P<0.05)between the two groups.Multivariate logistic regression analysis showed that patient position,consciousness status,nutritional risk,APACHE-II score,and length of nasogastric tube placement were independent factors influencing enteral nutrition aspiration in patients with AP during hospitalization(P<0.05).These factors were incorporated into the prediction model,which showed good consistency between the predicted and actual risks,as indicated by calibration curves with slopes close to 1 in the training and validation sets.Receiver operating characteristic analysis revealed an area under the curve(AUC)of 0.926(95%CI:0.8889-0.9675)in the training set.The optimal cutoff value is 0.73,with a sensitivity of 88.4 and specificity of 85.2.In the validation set,the AUC of the model for predicting enteral nutrition aspiration in patients with AP patients during hospitalization was 0.902,with a standard error of 0.040(95%CI:0.8284-0.9858),and the best cutoff value was 0.73,with a sensitivity of 91.9 and specificity of 81.8.CONCLUSION A prediction model for enteral nutrition aspiration during hospitalization in patients with AP was established and demonstrated high predictive value.Further clinical application of the model is warranted. 展开更多
关键词 Acute pancreatitis HOSPITALIZATION Enteral nutrition Predictive model ASPIRATION
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Clinical Evaluation of Enteral Nutrition+Probiotics in the Treatment of Gastrointestinal Dysfunction After Severe Traumatic Brain Injury
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作者 Lianyu Zhang 《Journal of Clinical and Nursing Research》 2024年第2期255-260,共6页
Objective:To evaluate the therapeutic effect of enteral nutrition+probiotics in patients with gastrointestinal dysfunction after severe craniocerebral injury.Methods:From September 2018 to February 2023,80 patients(20... Objective:To evaluate the therapeutic effect of enteral nutrition+probiotics in patients with gastrointestinal dysfunction after severe craniocerebral injury.Methods:From September 2018 to February 2023,80 patients(20-82 years old)with gastrointestinal dysfunction who were admitted to the Intensive Care Unit at the Third People’s Hospital of Xining were included in the study.Their primary condition was severe craniocerebral injury,and all of them received conventional symptomatic treatment.Group A received enteral nutrition+probiotic therapy,whereas group B received enteral nutrition only.The differences in the following indicators were compared before and after treatment:nutritional and biochemical indicators,gastrointestinal function indicators,Glasgow Coma Scale(GCS),Sequential Organ Failure Assessment(SOFA),APACHE II score,serum procalcitonin(PCT),neutrophil(N)ratio,and C reactive protein(CRP).Result:The nutritional and biochemical indicators in group A were higher than those in group B,P<0.05;the time to first passage of flatus,time to first passage of stool,and bowel sound recovery time in group A were shorter than those in group B,P<0.05;the GCS of group A was higher than that of group B,P<0.05;the SOFA and APACHEⅡscores of group A were not different from those of group B,P>0.05;and the PCT,N ratio,and CRP levels of group A were lower than those of group B,P<0.05.Conclusion:In patients with gastrointestinal dysfunction after severe craniocerebral injury,enteral nutrition+probiotic therapy is highly effective and feasible,as it can optimize various nutritional indicators,shorten the gastrointestinal function recovery time,and reduce the body’s stress response. 展开更多
关键词 Enteral nutrition PROBIOTICS Severe craniocerebral injury Gastrointestinal dysfunction EFFICACY
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Perioperative nutrition optimization:a review of the current literature
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作者 Jin-Shuai Li Wei-Bing Shuang 《Frontiers of Nursing》 2024年第2期127-137,共11页
Objective:This article aims to elaborate the recent research status of perioperative nutrition optimization,in order to help clinical practice.Methods:This study employed a comprehensive and systematic method to searc... Objective:This article aims to elaborate the recent research status of perioperative nutrition optimization,in order to help clinical practice.Methods:This study employed a comprehensive and systematic method to search prominent databases,including PubMed and Web of Science,using carefully selected keywords.Following meticulous screening,the inclusion of high-quality studies was prioritized,and a thorough review of the references was conducted to comprehensively analyze the latest evidence on perioperative nutrition optimization.Results:The main contents include preoperative nutritional risk screening and assessment,nutritional support pathway,immune enhancing nutrition,preoperative and postoperative nutritional management,as well as personalized nutrition optimization strategies for specific populations(such as children,bariatric surgery patients,and cancer patients).Conclusions:In clinical practice,the importance of perioperative nutrition should be emphasized,and personalized nutrition management plans should be developed based on the characteristics and needs of patients.Further research and promotion of perioperative nutrition optimization strategies will help improve the overall prognosis and quality of life of surgical patients. 展开更多
关键词 enteral nutrition immune enhancing nutrition nutritional screening and assessment parenteral nutrition PERIOPERATIVE
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Effect of Early Enteral Nutrition Combined with Probiotics on the Nutritional Status of Patients with Severe Craniocerebral Injury
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作者 Huaying Guan 《Journal of Clinical and Nursing Research》 2024年第5期260-265,共6页
Objective:To observe the effect of early enteral nutrition combined with probiotics on the nutritional status of patients with severe craniocerebral injury.Methods:Thirty-five patients with severe craniocerebral injur... Objective:To observe the effect of early enteral nutrition combined with probiotics on the nutritional status of patients with severe craniocerebral injury.Methods:Thirty-five patients with severe craniocerebral injury were divided into the study group(17 patients)and the control group(18 patients)according to the method of a randomized numerical table;both groups of patients started enteral nutrition via nasogastric tube within 24–48 hours after admission to the hospital,and probiotics were given in addition to the study group.Hemoglobin,total plasma protein,albumin,prealbumin,cholinesterase,fasting blood glucose,and other indexes were monitored before and early morning after enteral nutrition support,and upper arm circumference(AC),triceps skinfold thickness(TSF),and upper arm muscle circumference(AMC)were measured,and gastrointestinal response and time to first defecation of the patients were observed and compared with GCS score.Results:The hemoglobin,serum albumin,prealbumin,cholinesterase,and total plasma protein levels in the study group were significantly higher and fasting blood glucose levels were significantly lower than those in the control group after treatment(P<0.05).The incidence of reflux and constipation in the study group was lower than that in the control group,and the time to first defecation was shorter than that in the control group(P<0.05).After treatment,AC,TSF,and AMC were higher in the study group than in the control group(P<0.05).GCS scores were significantly higher in both groups after treatment,but the trend was more pronounced in the study group(P<0.05).Conclusion:Compared with simple enteral nutrition,enteral nutrition combined with probiotics can better correct metabolic disorders after heavy craniocerebral injury and improve the nutritional status of patients. 展开更多
关键词 Heavy craniocerebral injury Early enteral nutrition PROBIOTICS nutritional status
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Effect of Sequential Early Enteral Nutrition on Postoperative Rehabilitation and Complications in Gastric Cancer Patients
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作者 Dongchou Han Qiya Feng +3 位作者 Yingmei Fu Feijian Zhang Dazhen Chen Junmei Wu 《Proceedings of Anticancer Research》 2024年第2期59-64,共6页
Objective:To analyze the effect of sequential early enteral nutrition in patients with gastric cancer after surgery.Methods:A total of 139 gastric cancer patients,treated between October 2021 and October 2023,were ran... Objective:To analyze the effect of sequential early enteral nutrition in patients with gastric cancer after surgery.Methods:A total of 139 gastric cancer patients,treated between October 2021 and October 2023,were randomly selected and divided into two groups:Group A(68 cases,receiving early enteral nutrition)and Group B(71 cases,receiving sequential early enteral nutrition),using computer randomization.The effects of the interventions on both groups were compared.Results:Seven days post-operation,the levels of nutritional indicators in Group B were significantly higher than those in Group A(P<0.05).Group B showed significantly better levels of inflammatory factors and immune factors compared to Group A seven days post-operation(P<0.05).The postoperative complication rate in Group B was 4.23%,2 significantly lower than that in Group A,which was 16.18%(χ=5.477,P=0.019).Conclusion:The utilization of sequential early enteral nutrition in gastric cancer patients after surgery demonstrated notable improvements in nutritional status and inflammation markers,along with enhanced immunity,effectively reducing postoperative complications. 展开更多
关键词 Sequential early enteral nutrition Gastric cancer Postoperative rehabilitation treatment Complication rate
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A Study on the Effect of Staged Enteral Nutrition Health Education on the Rehabilitation of Patients with Upper Gastrointestinal Bleeding
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作者 Dalei Chen 《Journal of Clinical and Nursing Research》 2024年第7期322-327,共6页
Objective:To analyze the influence of stage-specific enteral nutrition health education on the rehabilitation outcomes of patients with upper gastrointestinal bleeding(UGIB).Methods:A total of 120 patients with UGIB,t... Objective:To analyze the influence of stage-specific enteral nutrition health education on the rehabilitation outcomes of patients with upper gastrointestinal bleeding(UGIB).Methods:A total of 120 patients with UGIB,treated between August 2021 and August 2023,were randomly divided into two groups:the observation group and the control group.The control group received standard enteral nutrition nursing intervention,while the observation group received an additional stage-specific enteral nutrition health education intervention based on the control group’s method.The intervention status of the two groups was then evaluated.Results:Before the intervention,the serum hemoglobin levels of the two groups were comparable(P>0.05).After the intervention,the nutritional indicators in the observation group improved significantly and were higher than those in the control group(P<0.05).Additionally,the observation group had shorter bed activity times and hospitalization periods,a lower rate of abandonment of nutritional preparations,and a higher quality of life compared to the control group(P<0.05).Conclusion:The implementation of stage-specific enteral nutrition health education in the treatment of patients with UGIB helps accelerate the rate of recovery,improve nutritional indexes,and enhance the quality of life of patients. 展开更多
关键词 Phased enteral nutrition health education Upper gastrointestinal bleeding Rehabilitation effect
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Evaluation of the Application Effect of Enteral and Parenteral Nutrition Therapy Combined with a Health Belief Education Model in Patients with Inflammatory Bowel Disease
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作者 Yangyan Chen 《Journal of Clinical and Nursing Research》 2024年第2期117-122,共6页
Objective:To evaluate the application effect of enteral and parenteral nutrition therapy combined with a health belief education model in patients with inflammatory bowel disease.Methods:80 patients with inflammatory ... Objective:To evaluate the application effect of enteral and parenteral nutrition therapy combined with a health belief education model in patients with inflammatory bowel disease.Methods:80 patients with inflammatory bowel disease admitted to the Shanghai Zhangjiang Institute of Medical Innovation were chosen.This study was carried out from August 2022 to October 2023.The patients were randomly divided into a study group(40 cases)and a control group(40 cases).The treatment plan for the control group was the conventional treatment model,while the treatment plan for the study group was to provide enteral and parenteral nutrition therapy combined with a health belief education model based on the control group.The efficacy of both groups was compared.Results:In the study group,the therapeutic effect for 31 patients(77.50%)was markedly effective and 7 was effective(17.50%),accounting for 95.0%of the total,which was higher than the control group at 80.0%(P<0.05).The relief time of relevant symptoms in the study group was shorter than that of the control group(P<0.05).Before treatment,there were no differences in the high-sensitivity C-reactive protein(hs-CRP),interleukin 10(IL-10),and tumor necrosis factor-α(TNF-α)between both groups(P>0.05).After treatment,the levels of inflammatory factors in the study group(hs-CRP(8.02±1.13)mg/L,IL-10(9.24±1.25)pg/mL,and TNF-α(7.19±1.04)ng/L)were lower than those in the control group(P<0.05).Conclusion:Enteral and parenteral nutritional therapy combined with a health belief education model showed significant efficacy in inflammatory bowel disease patients.Patient symptoms were relieved and inflammatory reactions were reduced.This method is worthy of popularization. 展开更多
关键词 Enteral and parenteral nutrition Health belief education Inflammatory bowel disease
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Gastroenteric tube feeding: Techniques, problems and solutions 被引量:72
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作者 Irina Blumenstein Yogesh M Shastri Jürgen Stein 《World Journal of Gastroenterology》 SCIE CAS 2014年第26期8505-8524,共20页
Gastroenteric tube feeding plays a major role in the management of patients with poor voluntary intake,chronic neurological or mechanical dysphagia or gut dysfunction,and patients who are critically ill.However,despit... Gastroenteric tube feeding plays a major role in the management of patients with poor voluntary intake,chronic neurological or mechanical dysphagia or gut dysfunction,and patients who are critically ill.However,despite the benefits and widespread use of enteral tube feeding,some patients experience complications.This review aims to discuss and compare current knowledge regarding the clinical application of enteral tube feeding,together with associated complications and special aspects.We conducted an extensive literature search on PubMed,Embase and Medline using index terms relating to enteral access,enteral feeding/nutrition,tube feeding,percutaneous endoscopic gastrostomy/jejunostomy,endoscopic nasoenteric tube,nasogastric tube,and refeeding syndrome.The literature showed common routes of enteral access to include nasoenteral tube,gastrostomy and jejunostomy,while complications fall into four major categories:mechanical,e.g.,tube blockage or removal;gastrointestinal,e.g.,diarrhea;infectious e.g.,aspiration pneumonia,tube site infection;and metabolic,e.g.,refeeding syndrome,hyperglycemia.Although the type and frequency of complications arising from tube feeding vary considerably according to the chosen access route,gastrointestinal complications are without doubt the most common.Complications associated with enteral tube feeding can be reduced by careful observance of guidelines,including those related to food composition,administration rate,portion size,food temperature and patient supervision. 展开更多
关键词 Enteral tube feeding Percutaneous endoscopic gastrostomy Refeeding syndrome Enteral nutrition Buried bumper syndrome Nasoenteral tubes Colocutaneous fistulae
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Effect of early enteral nutrition on postoperative nutritional status and immune function in elderly patients with esophageal cancer or cardiac cancer 被引量:69
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作者 Guiping Yu Guoqiang Chen +2 位作者 Bin Huang Wenlong Shao Guangqiao Zeng 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2013年第3期299-305,共7页
To explore the effect of early enteral nutrition (EN) on postoperative nutritional status, intestinal permeability, and immune 6anction in elderly patients with esophageal cancer or cardiac cancer. Methods: A total... To explore the effect of early enteral nutrition (EN) on postoperative nutritional status, intestinal permeability, and immune 6anction in elderly patients with esophageal cancer or cardiac cancer. Methods: A total of 96 patients with esophageal cancer or cardiac cancer who underwent surgical treatment in our hospital from June 2007 to December 2010 were enrolled in this study. They were divided into EN group (n=50) and parenteral nutrition (PN) group (n=46) based on the nutrition support modes. The body weight, time to first flatus/defecation, average hospital stay, complications and mortality after the surgery as well as the liver function indicators were recorded and analyzed. Peripheral blood samples were collected on the days 1, 4 and 7 after surgery. The plasma diamine oxidase (DAO) activity and D-lactate level were determined to assess the intestinal permeability. The plasma endotoxin levels were determined using dynamic turbidimetric assay to assess the protective effect of EN on intestinal mucosal barrier. The postoperative blood levels of inflammatory cytokines and immunoglobulins were determined using enzyme- linked immunosorbent assay (ELISA). Results: After the surgery, the time to first flatus/defecation, average hospital stay, and complications were significantly less in the EN group than those in the PN group (P〈0.05), whereas the EN group had significantly higher albumin levels than the PN group (P〈0.05). On the 7th postoperative day, the DAO activity, D-lactate level and endotoxin contents were significantly lower in the EN group than those in the PN group (all P〈0.05). In addition, the EN group had significantly higher IgA, IgG, IgM, and CD4 levels than the PN group (P〈0.05) but significantly lower IL-2, IL-6, and TNF-a levels (P〈0.05). Conclusions: In elderly patients with esophageal cancer or cardiac cancer, early EN after surgery can effectively improve the nutritional status, protect intestinal mucosal barrier (by reducing plasma endoxins), and enhance the immune function 展开更多
关键词 Enteral nutrition nutritional status intestinal permeability ENDOTOXIN immune function
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Enteral nutrition in acute pancreatitis:A review of the current evidence 被引量:81
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作者 Attila Oláh Laszlo Romics Jr 《World Journal of Gastroenterology》 SCIE CAS 2014年第43期16123-16131,共9页
The use of enteral feeding as part of the management of acute pancreatitis dates back almost two decades.This review describes the indications for and limitations of enteral feeding for the treatment of acute pancreat... The use of enteral feeding as part of the management of acute pancreatitis dates back almost two decades.This review describes the indications for and limitations of enteral feeding for the treatment of acute pancreatitis using up-to-date evidence-based data.A systematic review was carried out to analyse current data on the use of enteral nutrition in the management of acute pancreatitis.Relevant literature was analysed from the viewpoints of enteral vs parenteral feeding,early vs delayed enteral nutrition,nasogastric vs nasojejunal feeding,and early oral diet and immunonutrition,particularly glutamine and probiotic supplementation.Finally,current applicable guidelines and the effects of these guidelines on clinical practice are discussed.The latest meta-analyses suggest that enteral nutrition significantly reduces the mortality rate of severe acute pancreatitis compared to parenteral feeding.To maintain gut barrier function and prevent early bacterial translocation,enteral feeding should be commenced within the first 24 h of hospital admission.Also,the safety of nasogastric feeding,which eases the administration of enteral nutrients in the clinical setting,is likely equal to nasojejunal feeding.Furthermore,an earlylow-fat oral diet is potentially beneficial in patients with mild pancreatitis.Despite the initial encouraging results,the current evidence does not support the use of immunoenhanced nutrients or probiotics in patients with acute pancreatitis. 展开更多
关键词 Acute pancreatitis Enteral nutrition IMMUNOnutrition PROBIOTICS
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Perioperative artificial nutrition in malnourished gastrointestinal cancer patients 被引量:30
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作者 Guo-Hao Wu Zhong-Hua Liu Zhao-Han Wu Zhao-Guang Wu 《World Journal of Gastroenterology》 SCIE CAS CSCD 2006年第15期2441-2444,共4页
AIM: To investigate the potential role of perioperative nutrition in reducing complications and mortality in malnourished gastrointestinal cancer patients. METHODS: Four hundred and sixty-eight elective moderately o... AIM: To investigate the potential role of perioperative nutrition in reducing complications and mortality in malnourished gastrointestinal cancer patients. METHODS: Four hundred and sixty-eight elective moderately or severely malnourished surgical patients with gastric or colorectal cancers defined by the subjective global assessment (SGA) were randomly assigned to 7 d preoperative and 7 d postoperative parenteral or enteral nutrition vs a simple control group. The nutrition regimen included 24.6±5.2 kcal /kg per d non-protein and 0.23±0.04 g nitrogen /kg per d. Control patients did not receive preoperative nutrition but received 600±100 kcal non-protein plus or not plus 62 ± 16 g crystalline amino acids postoperatively. RESULTS: Complications occurred in 18.3% of the patients receiving nutrition and in 33.5% of the control patients (P= 0.012). Fourteen patients died in the control group and 5 in those receiving nutrition. There were significant differences in the mortality between the two groups (2.1% vs 6.0%, P=0.003). The total length of hospitalization and postoperative stay of control patients were significantly longer (29 vs 22 d, P=0.014) than those of the studied patients (23 vs 12 d, P= 0.000). CONCLUSION: Perioperative nutrition support is beneficial for moderately or severely malnourished gastrointestinal cancer patients and can reduce surgical complications and mortality. 展开更多
关键词 MALnutrition Perioperative nutrition Parenteral nutrition Enteral nutrition MORTALITY COMPLICATIONS
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Comparison of early enteral nutrition in severe acute pancreatitis with prebiotic fiber supplementation versus standard enteral solution:A prospective randomized double-blind study 被引量:54
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作者 Tarkan Karakan Meltem Ergun +2 位作者 Ibrahim Dogan Mehmet Cindoruk Selahattin Unal 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第19期2733-2737,共5页
AIM: To compare the benefi cial effects of early enteral nutrition (EN) with prebiotic fiber supplementation in patients with severe acute pancreatitis (AP).METHODS: Thirty consecutive patients with severe AP, who req... AIM: To compare the benefi cial effects of early enteral nutrition (EN) with prebiotic fiber supplementation in patients with severe acute pancreatitis (AP).METHODS: Thirty consecutive patients with severe AP, who required stoppage of oral feeding for 48 h, were randomly assigned to nasojejunal EN with or without prebiotics. APACHE Ⅱ score, Balthazar’s CT score and CRP were assessed daily during the study period.RESULTS: The median duration of hospital stay was shorter in the study group [10 ± 4 (8-14) d vs 15 ± 6 (7-26) d] (P < 0.05). The median value of days in intensive care unit was also similar in both groups [6 ± 2 (5-8) d vs 6 ± 2 (5-7) d]. The median duration of EN was 8 ± 4 (6-12) d vs 10 ± 4 (6-13) d in the study and control groups, respectively (P > 0.05). Deaths occurred in 6 patients (20%), 2 in the study group and 4 in the control group. The mean duration of APACHE Ⅱ normalization (APACHE Ⅱ score < 8) was shorter in the study group than in the control group (4 ± 2 d vs 6.5 ± 3 d, P < 0.05). The mean duration of CRP normalization was also shorter in the study group than in the control group (7 ± 2 d vs 10 ± 3 d, P < 0.05).CONCLUSION: Nasojejunal EN with prebiotic fiber supplementation in severe AP improves hospital stay, duration nutrition therapy, acute phase response and overall complications compared to standard EN therapy. 展开更多
关键词 Severe acute pancreatitis PREBIOTICS Enteral nutrition Treatment
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Effects of Saccharomycesboulardiion fecal short-chain fatty acids and microflora in patients on long-term total enteral nutrition 被引量:29
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作者 Stéphane M Schneider Fernand Girard-Pipau +5 位作者 Jér(o|^)me Filippi Xavier Hébuterne Dominique Moyse Gustavo Calle Hinojosa Anne Pompei Patrick Rampal 《World Journal of Gastroenterology》 SCIE CAS CSCD 2005年第39期6165-6169,共5页
AIM: To assess the effects of Sb on fecal flora and shortchain fatty acids (SCFA) in patients on long-term TEN. METHODS: Ten patients (3 females, 7 males, 59±5.5 years), on TEN for a median of 13 mo (1-125... AIM: To assess the effects of Sb on fecal flora and shortchain fatty acids (SCFA) in patients on long-term TEN. METHODS: Ten patients (3 females, 7 males, 59±5.5 years), on TEN for a median of 13 mo (1-125), and 15 healthy volunteers (4 females, 11 males, 32±2.0 years) received Sb (0.5 g bid PO) for 6 d. Two stool samples were taken before, on the last 2 d and 9-10 d after treatment, for SCFA measurement and for culture and bacterial identification. Values (mean4-SE) were compared using sign tests and ANOVA. RESULTS: Fecal butyrate levels were lower in patients (10.1±2.9 mmol/kg) than in controls (19.2±3.9, P= 0.02). Treatment with Sb increased total fecal SCFA levels in patients (150.2+27.2 vs 107.5±18.2 mmol/kg, P= 0.02) but not in controls (129.0±28.6 vs 113.0±15.2 mmol/kg, NS). At the end of treatment with Sb, patients had higher fecal butyrate(16.0±4.4 vs 10.1 [2.9] mmol/kg, P= 0.004). Total SCFAs remained high 9 d after treatment was discontinued. Before the treatment, the anaerobe to aerobe ratio was lower in patients compared to controls (2.4±2.3 vs 69.8±1.8, P= 0.003). There were no significant changes in the fecal flora of TEN patients. CONCLUSION: Sb-induced increase of fecal SCFA concentrations (especially butyrate) may explain the preventive effects of this yeast on TEN-induced diarrhea. 展开更多
关键词 Enteral nutrition DIARRHEA Saccharomyces boulardii Short-chain fatty acids Intestinal microbiota
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Influences of enteral nutrition combined with probiotics on gut microflora and barrier function of rats with abdominal infection 被引量:23
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作者 Tong-Yi Shen Huan-Long Qin Zhi-Guang Gao Xiao-Bing Fan Xiao-Ming Hang Yan-Qun Jiang 《World Journal of Gastroenterology》 SCIE CAS CSCD 2006年第27期4352-4358,共7页
AIM: To investigate the influences of enteral, parenteral nutrition and probiotics delivered by gut on intestinal microecology, epithelial tight junctions, immune and barrier function of rats with abdominal infection... AIM: To investigate the influences of enteral, parenteral nutrition and probiotics delivered by gut on intestinal microecology, epithelial tight junctions, immune and barrier function of rats with abdominal infection. METHODS: Rat abdominal infection models established with cecal ligation and perforation method, were divided into three groups: parenteral nutrition (PN group, n = 7), PN+enteral nutrition (EN group, n = 7) and PN + EN + probiotics (probiotics group, n = 7) via the needle jejunostomy and neck vein for five days. The total nutritional supplement of the three groups was isonitrogenic and isocaloric. Probiotics was delivered by jejunostomy 10 mL/d (1 x 10^8 cfu/mL). The rats were killed on the sixth day. The feces in the cecum were cultured for anaerobic bacterial growth and analyzed with bacterial group DNA fingerprint profile with random amplified polymorphic DNA. The transmembrane binding proteins (occludin) and IgA level in plasma cells of intestine epithelium in colon and terminal ileum were measured by an immunohistochemistry method. The ultrastructure of intestinal epithelial tight junctions in colon and small intestine was observed by electronmicroscopy. Vena cava blood and the homogenated tissue of liver, lung and mesenteric lymph nodes were cultured to determine the bacterial translocations, and endotoxin in the blood from portal vein was detected. RESULTS: (1) The amount of bacteria of gut species in EN group and probiotic group was higher than that in PN group. The DNA-proflles in EN group and probiotic group were similar to that of normal rats. The number of DNAprofiles in probiotics group was much more than that in PN group and EN group. Moreover, there were strange stripes in PN group. (2) The expression of occludin and IgA in the small and large intestine in EN group (2.309 ± 0.336, 15.440 ± 2.383) and probiotic group (2.938 ± 0.515, 16.230 ± 3.183) was improved as compared with PN group (1.207 ± 0.587, P 〈 0.05, 11.189 ± 2.108, P 〈 0.01). The expression of occludin in probiotic group (intestine: 2.93 ± 0.515; cecum: 3.40 ± 0.617) was higher than that in EN group (intestine: 2.309 ± 0.336; cecum: 2.076 ± 0.670; P 〈 0.05). The expression of IgA, especially in EN group (intestine: 15.440 ± 2.383) and probiotic EN group (large intestine: 12.516 ± 1.542) significantly increased as compared with PN group (intestine: 11.189 ± 2.108; cecum: 10.160 ± 1.643; P 〈 0.01). The intestinal epithelial tight junctions and microvilli of the probiotic group were more intact than those in the PN group. (3) The bacterial translocations in blood, liver, lung and mesenteric lymph nodes, and the levels of endotoxin were significantly reduced in probiotic (0.082 ± 0.029) and EN (0.125 ± 0.040) groups as compared with PN group (0.403 ± 0.181, P 〈 0.05). CONCLUSION: Application of EN combined with probiotics could improve the expression of transmembrane binding proteins (occludin) and IgA, correct the intestinal flora disturbance, maintain gut barrier functions and tight junctions, and reduce the occurrence of gut bacterial translocation. 展开更多
关键词 PROBIOTICS Enteral nutrition Gut flora Transmembrane binding proteins Gut barrier function
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Early nasogastric enteral nutrition for severe acute pancreatitis: A systematic review 被引量:21
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作者 Kun Jiang Xin-Zu Chen +2 位作者 Qing Xia Wen-Fu Tang Lei Wang 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第39期5253-5260,共8页
AIM: To evaluate the effectiveness and safety of early nasogastric enteral nutrition (NGEN) for patients with severe acute pancreatitis (SAP). METHODS: We searched Cochrane Central Register of Controlled Trials (Issue... AIM: To evaluate the effectiveness and safety of early nasogastric enteral nutrition (NGEN) for patients with severe acute pancreatitis (SAP). METHODS: We searched Cochrane Central Register of Controlled Trials (Issue 2, 2006), Pub-Medline (1966-2006), and references from relevant articles. We included randomized controlled trials (RCTs) only, which reported the mortality of SAP patients at least. Two reviewers assessed the quality of each trial and collected data independently. The Cochrane Collaboration’s RevMan 4.2.9 software was used for statistical analysis. RESULTS: Three RCTs were included, involving 131 patients. The baselines of each trial were comparable. Meta-analysis showed no significant differences in mortality rate of SAP patients between nasogastric and conventional routes (RR = 0.76, 95% CI = 0.37 and 1.55, P = 0.45), and in other outcomes, including time of hospital stay (weighted mean difference = -5.87, 95% CI = -20.58 and 8.84, P = 0.43), complication rate of infection (RR = 1.41, 95% CI = 0.62 and 3.23, P = 0.41) or multiple organ defi ciency syndrome (RR = 0.97, 95% CI = 0.27 and 3.47, P = 0.97), rate of admission to ICU (RR = 1.00, 95% CI = 0.48 and 2.09, P = 0.99) or conversion to surgery (RR = 0.66, 95% CI = 0.12 and 3.69, P = 0.64), as well as recurrence of re-feeding pain and adverse events associated with nutrition. CONCLUSION: Early NGEN is a breakthrough in the management of SAP. Based on current studies, early NGEN appears effective and safe. Since the available evidence is poor in quantity, it is hard to make an accurate evaluation of the role of early NGEN in SAP.Before recommendation to clinical practice, further high qualified, large scale, randomized controlled trials are needed. 展开更多
关键词 Enteral nutrition Nasogastric tube Severe acute pancreatitis Systematic review META-ANALYSIS
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Modified B-ultrasound method for measurement of antral section only to assess gastric function and guide enteral nutrition in critically ill patients 被引量:29
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作者 Ying Liu Ya-Kun Gao +1 位作者 Lei Yao Li Li 《World Journal of Gastroenterology》 SCIE CAS 2017年第28期5229-5236,共8页
AIM To establish a modified B-ultrasound method of measuring the antral section only to assess gastric motility in healthy people,and evaluate its application in guiding enteral nutrition(EN) in critically ill patient... AIM To establish a modified B-ultrasound method of measuring the antral section only to assess gastric motility in healthy people,and evaluate its application in guiding enteral nutrition(EN) in critically ill patients. METHODS First,30 healthy volunteers were selected. The modified B-ultrasound method and the traditional B-ultrasound method were applied to assess gastric function. The correlation of indices of gastric function between the two groups was analyzed statistically. In addition,64 critically ill patients were selected,and the modified B-ultrasound method and the gastric juice withdrawal method were applied to guide the implementation of EN. Daily caloric value,the time required to achieve complete EN,ICU stay,hospitalization time,and serum prealbumin and albumin levels were recorded and compared between the two groups. Kaplan-Meier survival curve was used to compare the complications of EN between the two groups. RESULTS In healthy subjects,there was a good correlation among gastric emptying time,antral contraction frequency andantral motility index between the two groups(r = 0.57,0.61 and 0.54,respectively). The study on critically ill patients also revealed that a better effect of EN was achieved in the modified B-ultrasound method group,in which patients had shorter ICU stay and hospitalization time and higher levels of serum prealbumin and albumin. The Kaplan-Meier survival analysis revealed that the improved B-ultrasound method was associated with significantly fewer EN complications(P = 0.031).CONCLUSION The modified B-ultrasound method can provide a good real-time assessment of gastric function and has a better effect than the traditional method in guiding EN in critically ill patients. 展开更多
关键词 Gastric emptying Real-time ultrasound Critically ill patients Enteral nutrition
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