AIM:To compare fluoroscopic, endoscopic and guide wire assistance with ultraslim gastroscopy for placement of nasojejunal feeding tubes. METHODS:The information regarding nasojejunal tube placement procedures was retr...AIM:To compare fluoroscopic, endoscopic and guide wire assistance with ultraslim gastroscopy for placement of nasojejunal feeding tubes. METHODS:The information regarding nasojejunal tube placement procedures was retrieved using the gastrointestinal tract database at Tongji Hospital affiliated to Tongji Medical College. Records from 81 patients who underwent nasojejunal tubes placement by different techniques between 2004 and 2011 were reviewed for procedure success and tube-related outcomes. RESULTS:Nasojejunal feeding tubes were successfully placed in 78 (96.3%) of 81 patients. The success rate by fluoroscopy was 92% (23 of 25), by endoscopic technique 96.3% (26 of 27), and by guide wire assistance (whether via transnasal or transoral insertion)100% (23/23, 6/6). The average time for successful placement was 14.9 ± 2.9 min for fluoroscopic placement, 14.8 ± 4.9 min for endoscopic placement, 11.1 ± 2.2 min for guide wire assistance with transnasal gastroscopic placement, and 14.7 ± 1.2 min for transoral gastroscopic placement. Statistically, the duration for the third method was significantly different (P < 0.05) compared with the other three methods. Transnasal placement over a guidewire was significantly faster (P < 0.05) than any of the other approaches. CONCLUSION:Guide wire assistance with transnasal insertion of nasojejunal feeding tubes represents a safe, quick and effective method for providing enteral nutrition.展开更多
BACKGROUND: Total parenteral nutrition (TPN) has been recognized as the mainstay of nutritional support in patients with severe hepatopancreatobiliary (HPB) diseases for decades. However, recent studies advocate the u...BACKGROUND: Total parenteral nutrition (TPN) has been recognized as the mainstay of nutritional support in patients with severe hepatopancreatobiliary (HPB) diseases for decades. However, recent studies advocate the utilization of endoscopic nasojejunal feeding tube placement (ENFTP), rather than the conventional approach. This study was designed to compare the clinical value of ENFTP and TPN in patients with severe HPB diseases. METHODS: Two groups of patients with severe HPB diseases were analyzed retrospectively. One group of 88 patients received ENFTP, and the other 96 received TPN. Routine blood levels, serum glucose and prealbumin, hepatic and renal function, serum lipid, and calcium were measured at baseline and after 1, 2, and 4 weeks of nutritional support. Also, complication rate, mortality, nutritional support time, mechanical ventilation time, mean length of time in intensive care unit, and duration of hospital stay were analyzed. RESULTS: After 4 weeks of nutritional support, the degree of recovery of red blood cells, prealbumin, and blood glucose was greater in the ENFTP than in the TPN group (P<0.05). Furthermore, the ENFTP group showed a lower incidence of septicemia, multiple organ dysfunction syndrome, peripancreatic infection, biliary infection, and nosocomial infection, in addition to shorter nutritional support time and hospital stay (P<0.05). CONCLUSIONS: ENFTP is much more effective than TPN in assisting patients with severe HPB diseases to recover from anemia, low prealbumin level, and high serum glucose, as well as in decreasing the rates of various infections (pulmonary infection excluded), multiple organ dysfunction syndrome rate, nutrition support time, and length of hospital stay. Therefore, ENFTP is safer and more economical for clinical application.展开更多
目的:通过文献检索分析评价磁导航引导鼻空肠管置管技术在危重症患者鼻空肠管置管中的应用效果。方法:检索中国知网、万方、维普和中国生物医学文献服务系统中文数据库,以及外文数据库PubMed、CINAHL、Cochrane Library、Web of Science...目的:通过文献检索分析评价磁导航引导鼻空肠管置管技术在危重症患者鼻空肠管置管中的应用效果。方法:检索中国知网、万方、维普和中国生物医学文献服务系统中文数据库,以及外文数据库PubMed、CINAHL、Cochrane Library、Web of Science、Embase中关于磁导航引导鼻空肠管置管技术在危重症患者中应用的随机对照试验研究文献,检索时间为2000年1月至2023年9月。检索文献950篇,按照文献纳入与排除标准筛选文献,并对文献进行质量评价,运用RevMan 5.4.1软件对文献中的置管成功率、置管成功所需时间,患者体征恢复时间和满意度4项结局指标进行Meta分析,比较磁导航引导鼻空肠管置管与床旁盲插鼻空肠管的差异。结果:最终纳入7篇文献的7项随机对照试验研究,其中中文文献4篇,英文文献3篇,7篇文献涉及682例患者。磁导航引导鼻空肠管置管成功率高于床旁盲插鼻空肠管,差异有统计学意义[优势比(OR)=4.78,95%置信区间(CI)为(2.16~10.58),P<0.0001];磁导航引导鼻空肠管置管所需时间少于床旁盲插鼻空肠管,差异有统计学意义[均数差(MD)=-12.91,95%CI(-22.93~-2.90),P<0.00001];磁导航引导鼻空肠管置管患者体征恢复时间少于床旁盲插鼻空肠管,差异有统计学意义[MD=-9.11,95%CI(-12.09~-6.13),P<0.00001];磁导航引导鼻空肠管置管的患者满意度高于床旁盲插鼻空肠管患者,差异有统计学意义[OR=11.61,95%CI(3.96~34.01),P<0.00001]。结论:磁导航引导鼻空肠管置管相比床旁盲插鼻空肠管,可显著提高危重症患者鼻空肠管置管成功率,减少鼻空肠管置管成功所需时间和患者体征恢复时间,提高患者满意度。展开更多
Objective:To analyze the effect of enteral nutrition and nursing intervention in patients with indwelling nasojejunal tube in acute severe pancreatitis.Methods:Sixty cases of patients with indwelt nasojejunal tubes tr...Objective:To analyze the effect of enteral nutrition and nursing intervention in patients with indwelling nasojejunal tube in acute severe pancreatitis.Methods:Sixty cases of patients with indwelt nasojejunal tubes treated in our hospital from August 2019 to August 2020 were divided into routine group and observation group as research subjects.Patients in both groups received enteral nutrition,patients in the routine group received routine care,and patients in the observation group received quality care.The recovery time of gastrointestinal function,length of hospital stay,hospitalization cost,nutritional indicators and incidence of complications in the two groups were compared.Results:The recovery time of gastrointestinal function in observation group was lower than that in routine group,P<0.05;The length and cost of hospitalization in observation group were lower than those in routine group,P<0.05;The nutritional indexes in observation group were higher than those in routine group,P<0.05;The incidence of complications in observation group was lower than that in routine group,P<0.05.Conclusion:Quality nursing service improve the effect of enteral nutrition,so as to ensure that patients get sufficient nutritional support.Its effect is remarkable and it is worthy of widespread clinical application.展开更多
文摘AIM:To compare fluoroscopic, endoscopic and guide wire assistance with ultraslim gastroscopy for placement of nasojejunal feeding tubes. METHODS:The information regarding nasojejunal tube placement procedures was retrieved using the gastrointestinal tract database at Tongji Hospital affiliated to Tongji Medical College. Records from 81 patients who underwent nasojejunal tubes placement by different techniques between 2004 and 2011 were reviewed for procedure success and tube-related outcomes. RESULTS:Nasojejunal feeding tubes were successfully placed in 78 (96.3%) of 81 patients. The success rate by fluoroscopy was 92% (23 of 25), by endoscopic technique 96.3% (26 of 27), and by guide wire assistance (whether via transnasal or transoral insertion)100% (23/23, 6/6). The average time for successful placement was 14.9 ± 2.9 min for fluoroscopic placement, 14.8 ± 4.9 min for endoscopic placement, 11.1 ± 2.2 min for guide wire assistance with transnasal gastroscopic placement, and 14.7 ± 1.2 min for transoral gastroscopic placement. Statistically, the duration for the third method was significantly different (P < 0.05) compared with the other three methods. Transnasal placement over a guidewire was significantly faster (P < 0.05) than any of the other approaches. CONCLUSION:Guide wire assistance with transnasal insertion of nasojejunal feeding tubes represents a safe, quick and effective method for providing enteral nutrition.
文摘BACKGROUND: Total parenteral nutrition (TPN) has been recognized as the mainstay of nutritional support in patients with severe hepatopancreatobiliary (HPB) diseases for decades. However, recent studies advocate the utilization of endoscopic nasojejunal feeding tube placement (ENFTP), rather than the conventional approach. This study was designed to compare the clinical value of ENFTP and TPN in patients with severe HPB diseases. METHODS: Two groups of patients with severe HPB diseases were analyzed retrospectively. One group of 88 patients received ENFTP, and the other 96 received TPN. Routine blood levels, serum glucose and prealbumin, hepatic and renal function, serum lipid, and calcium were measured at baseline and after 1, 2, and 4 weeks of nutritional support. Also, complication rate, mortality, nutritional support time, mechanical ventilation time, mean length of time in intensive care unit, and duration of hospital stay were analyzed. RESULTS: After 4 weeks of nutritional support, the degree of recovery of red blood cells, prealbumin, and blood glucose was greater in the ENFTP than in the TPN group (P<0.05). Furthermore, the ENFTP group showed a lower incidence of septicemia, multiple organ dysfunction syndrome, peripancreatic infection, biliary infection, and nosocomial infection, in addition to shorter nutritional support time and hospital stay (P<0.05). CONCLUSIONS: ENFTP is much more effective than TPN in assisting patients with severe HPB diseases to recover from anemia, low prealbumin level, and high serum glucose, as well as in decreasing the rates of various infections (pulmonary infection excluded), multiple organ dysfunction syndrome rate, nutrition support time, and length of hospital stay. Therefore, ENFTP is safer and more economical for clinical application.
文摘目的:通过文献检索分析评价磁导航引导鼻空肠管置管技术在危重症患者鼻空肠管置管中的应用效果。方法:检索中国知网、万方、维普和中国生物医学文献服务系统中文数据库,以及外文数据库PubMed、CINAHL、Cochrane Library、Web of Science、Embase中关于磁导航引导鼻空肠管置管技术在危重症患者中应用的随机对照试验研究文献,检索时间为2000年1月至2023年9月。检索文献950篇,按照文献纳入与排除标准筛选文献,并对文献进行质量评价,运用RevMan 5.4.1软件对文献中的置管成功率、置管成功所需时间,患者体征恢复时间和满意度4项结局指标进行Meta分析,比较磁导航引导鼻空肠管置管与床旁盲插鼻空肠管的差异。结果:最终纳入7篇文献的7项随机对照试验研究,其中中文文献4篇,英文文献3篇,7篇文献涉及682例患者。磁导航引导鼻空肠管置管成功率高于床旁盲插鼻空肠管,差异有统计学意义[优势比(OR)=4.78,95%置信区间(CI)为(2.16~10.58),P<0.0001];磁导航引导鼻空肠管置管所需时间少于床旁盲插鼻空肠管,差异有统计学意义[均数差(MD)=-12.91,95%CI(-22.93~-2.90),P<0.00001];磁导航引导鼻空肠管置管患者体征恢复时间少于床旁盲插鼻空肠管,差异有统计学意义[MD=-9.11,95%CI(-12.09~-6.13),P<0.00001];磁导航引导鼻空肠管置管的患者满意度高于床旁盲插鼻空肠管患者,差异有统计学意义[OR=11.61,95%CI(3.96~34.01),P<0.00001]。结论:磁导航引导鼻空肠管置管相比床旁盲插鼻空肠管,可显著提高危重症患者鼻空肠管置管成功率,减少鼻空肠管置管成功所需时间和患者体征恢复时间,提高患者满意度。
文摘Objective:To analyze the effect of enteral nutrition and nursing intervention in patients with indwelling nasojejunal tube in acute severe pancreatitis.Methods:Sixty cases of patients with indwelt nasojejunal tubes treated in our hospital from August 2019 to August 2020 were divided into routine group and observation group as research subjects.Patients in both groups received enteral nutrition,patients in the routine group received routine care,and patients in the observation group received quality care.The recovery time of gastrointestinal function,length of hospital stay,hospitalization cost,nutritional indicators and incidence of complications in the two groups were compared.Results:The recovery time of gastrointestinal function in observation group was lower than that in routine group,P<0.05;The length and cost of hospitalization in observation group were lower than those in routine group,P<0.05;The nutritional indexes in observation group were higher than those in routine group,P<0.05;The incidence of complications in observation group was lower than that in routine group,P<0.05.Conclusion:Quality nursing service improve the effect of enteral nutrition,so as to ensure that patients get sufficient nutritional support.Its effect is remarkable and it is worthy of widespread clinical application.
