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
OBJECTIVE:To investigate the clinical effects of modified Dachengqi Tang(DCQT) on promoting gastrointestinal motility in post-operative esophageal cancer patients.METHODS:Sixty postoperative esophageal cancer patients...OBJECTIVE:To investigate the clinical effects of modified Dachengqi Tang(DCQT) on promoting gastrointestinal motility in post-operative esophageal cancer patients.METHODS:Sixty postoperative esophageal cancer patients were enrolled and randomly assigned to the modified treatment group or the control group(30 patients in each group).Patients in the treatment group were given DCQT made from decocted herbs and administered via nasojejunal tube at a dosage of 150 mL.Gastrointestinal motility was assessed by recording time for recovery of bowel sounds,flatus,defecation,and the total amount of gastric drainage during the first three postoperative days.Plasma motilin(MTL) and vasoactive intestinal peptide(VIP) were measured one hour before and three days after surgery.RESULTS:Compared with the control group,the times to first bowel sound,flatus,and defecation were significantly shorter and there was less gastric drainage in the treatment group(P < 0.01,P < 0.01,P < 0.01,and P < 0.05,respectively).In the treatment group,postoperative plasma MTL was significantly higher(P < 0.01) and VIP was significantly lower than those in the control group(P < 0.05).There was no difference found in either MTL or VIP from before to after operation in the treatment group(P > 0.05).MTL was significantly lower and VIP was higher postoperatively in the control group,compared to before surgery(P < 0.01).CONCLUSION:Modified DCQT effectively improved decreased gastrointestinal motility in postoperative esophageal cancer patients by increasing MTL and reducing VIP.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
Postpyloric feeding is an important and promising alternative to parenteral nutrition. The indications for this kind of feeding are increasing and include a variety of clinical conditions, such as gastroparesis, acute...Postpyloric feeding is an important and promising alternative to parenteral nutrition. The indications for this kind of feeding are increasing and include a variety of clinical conditions, such as gastroparesis, acute pancreatitis, gastric outlet stenosis, hyperemesis (including gravida), recurrent aspiration, tracheoesophageal fistula and stenosis in gastroenterostomy. This review discusses the differences between pre- and postpyloric feeding, indications and contraindications, advantages and disadvantages, and provides an overview of the techniques of placement of various postpyloric devices.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.
基金the Administration of Shandong Provincial Traditional Chinese Medicine,China,No.2009-166
文摘OBJECTIVE:To investigate the clinical effects of modified Dachengqi Tang(DCQT) on promoting gastrointestinal motility in post-operative esophageal cancer patients.METHODS:Sixty postoperative esophageal cancer patients were enrolled and randomly assigned to the modified treatment group or the control group(30 patients in each group).Patients in the treatment group were given DCQT made from decocted herbs and administered via nasojejunal tube at a dosage of 150 mL.Gastrointestinal motility was assessed by recording time for recovery of bowel sounds,flatus,defecation,and the total amount of gastric drainage during the first three postoperative days.Plasma motilin(MTL) and vasoactive intestinal peptide(VIP) were measured one hour before and three days after surgery.RESULTS:Compared with the control group,the times to first bowel sound,flatus,and defecation were significantly shorter and there was less gastric drainage in the treatment group(P < 0.01,P < 0.01,P < 0.01,and P < 0.05,respectively).In the treatment group,postoperative plasma MTL was significantly higher(P < 0.01) and VIP was significantly lower than those in the control group(P < 0.05).There was no difference found in either MTL or VIP from before to after operation in the treatment group(P > 0.05).MTL was significantly lower and VIP was higher postoperatively in the control group,compared to before surgery(P < 0.01).CONCLUSION:Modified DCQT effectively improved decreased gastrointestinal motility in postoperative esophageal cancer patients by increasing MTL and reducing VIP.
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Postpyloric feeding is an important and promising alternative to parenteral nutrition. The indications for this kind of feeding are increasing and include a variety of clinical conditions, such as gastroparesis, acute pancreatitis, gastric outlet stenosis, hyperemesis (including gravida), recurrent aspiration, tracheoesophageal fistula and stenosis in gastroenterostomy. This review discusses the differences between pre- and postpyloric feeding, indications and contraindications, advantages and disadvantages, and provides an overview of the techniques of placement of various postpyloric devices.
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.
