A new transnasal approach of the placement of jejunal feeding tube intraoperatively for upper digestive tract malformation newborn

作者：耿其明; 吕小逢; 张杰; 蒋维维; 李薇; 陈焕; 路长贵; 李波; 唐维兵; 徐小群

来源：临床小儿外科杂志, 2014, (3).

• Jejunum
• Enteral Nutrition
• Gastrointestinal Tract/AB
• Infant,Newborn

Objetive To accomplish early enteral feeding in upper digestive tract malformation new-born,a new transnasal approach to the placement of postpyloric enteral nutrition tubes intraoperatively was eval-uated. Methods Retrospective review the clinical data of 104 newborn cases about duodenal,jejunal congeni-tal obstruction treated in Neonatal Surgery Department of Nanjing Children’s Hospital from January 2010 to June 2013.According to whether transnasal approach to the placement of postpyloric enteral nutrition tubes intr-aoperatively,patients were divided into two groups:indwelling tube group(n=54),control group(n=50).The gestational age,birth weight,age at surgery,time of anesthesia,time of operation,time for intestinal function re-covery (the time of oral feeding of 40 mL/3 h postoperative ),and complications were evaluated. Results There were no significant differences in gestational age,birth weight and age at surgery between the two groups. The time of anesthesia (131.9 ±13.5 m)vs (128.7 ±12.6 m)and operation time (114.1 ±13.2 m)vs (110.5 ±15.3 m)of two groups showed no statistical difference (P> 0.05);However the time of oral feeding up to 40 mL/3 h postoperative (17.7 ±5.1 d)in indwelling tube group was significantly shorter than that in control group ((21.4 ±7.4d),P <0.05).There were no tube plugging complications such as intestinal perfo-ration,intestinal volvulus,no adhesive intestinal obstruction occurred,only one case of cholestasis in indwelling tube group.In contrast,with four cases of function of intestinal obstruction postoperation,three cases of adhesive intestinal obstruction and 6 cases of cholestasis in the control group,occurrence rate was significantly increased than indwelling tube group. Conclusion It is simple,with no trauma and little complications,and can improve the feeding tolerance to place jejunal feeding tube transnasal in upper digestive tract malformation neonate intra-operatively.It provides a safe,effective approach for early enteral nutrition after gastrointestinal operation in newborns.

• 出版日期2014
• 单位南京医科大学