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Endoscopic nasojejunal feeding tube placement in patients with severe hepatopancreatobiliary diseases:a retrospective study of 184 patients

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Hepatobiliary & Pancreatic Diseases International 2010年第1期9卷 54-59页

作者： Ji, Feng Zhao, Jing-Li Jin, Xi Jiao, Chun-Hua Hu, Yu-Yao Xu, Qin-Wei Chen, Wei-Xing Zhejiang Univ Sch Med Affiliated Hosp 1 Dept Gastroenterol Hangzhou 310003 Zhejiang Peoples R China

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 (Pnutritional support time and hospital stay (Pnutrition support time, and length of hospital stay. Therefore, ENFTP is safer and more economical for clinical application.

关键词： tube feeding, nasojejunal endoscopy parenteral nutrition, total hepatobiliary disease pancreatic disease

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Effect of bowel rehabilitative therapy on structural adaptation of remnant small intestine: animal experiment

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World Journal of Gastroenterology 2001年第1期7卷 66-73页

作者： Xin Zhou1 Yuan Xin Li2 Ning Li2 Jie Shou Li2 1Department of General Surgery, Medical School, Nanjing University, Nanjing 210093. Jiangsu Province. China2Research Institute of General Hospital. Chinese PLA General Hospital of Nanjing Military Area, Nanjing 210002. Jiangsu Province. China Research Institute of General Surgery Chinese PLA General Hospital of Nanjing Military Area 305 East Zhongshan Road Nanjing 210002 Jiangsu Province China.

AIM: To investigate the individual and the combined effects of glutamine, dietary fiber, and growth hormone on the structural adaptation of the remnant small bowel. METHODS: Forty-two adult male Sprague-Dawley rats underwent 85% mid-small bowel resection and received total parenteral nutrition (TPN) support during the first three postoperational *** the 4th postoperational day, animals were randomly assigned to receive 7 different treatments for 8 days: TPNcon group, receiving TPN and enteral 20 g x L(-1) glycine perfusion; TPN+Gln group, receiving TPN and enteral 20 g x L(-1) glutamine perfusion; ENcon group, receiving enteral nutrition (EN) fortified with 20 g x L(-1) glycine; EN+Gln group, enteral nutrition fortified with 20 g x L(-1) glutamine; EN+Fib group, enteral nutrition and 2 g x d(-1) oral soybean fiber; EN+GH group, enteral nutrition and subcutaneous growth hormone (GH) (0.3 IU) injection twice daily; and ENint group, glutamine-enriched EN, oral soybean fiber, and subcutaneous GH injection. RESULTS: Enteral glutamine perfusion during TPN increased the small intestinal villus height (jejunal villus height 250 microm +/- 29 microm in TPNcon vs 330 microm +/- 54 microm in TPN+Gln, ileal villus height 260 microm +/- 28 microm in TPNcon vs 330 microm +/- 22 microm in TPN+Gln, P<0.05) and mucosa thickness (jejunal mucosa thickness 360 microm +/- 32 microm in TPNcon vs 460 microm +/- 65 microm in TPN+Gln, ileal mucosa thickness 400 microm +/- 25 microm in TPNcon vs 490 microm +/- 11 microm in TPN+Gln,P< 0.05) in comparison with the TPNcon group. Either fiber supplementation or GH administration improved body mass gain (end body weight 270 g +/- 3.6g in EN+Fib, 265.7 g +/- 3.3 g in EN+GH, vs 257 g +/- 3.3 g in ENcon, P< 0.05), elevated plasma insulin-like growth factor (IGF-I) level (880 microg x L(-1). 52 microg x L-(-1) in EN+Fib,1200 microg x L(-1). 96 microg x L-(-1) in EN +/- GH, vs 620 microg x L(-1).43 microg x L-(-1) in ENcon, P< 0.05),

关键词： parenteral nutrition, total Adaptation, Physiological Animals Body Weight Dietary Fiber Glutamine Glycine Growth Hormone Insulin-Like Growth Factor I Intestinal Mucosa Intestine, Small Male Rats Rats, Sprague-Dawley Recovery of Function Research Support, Non-U.S. Gov't Short Bowel Syndrome

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