We hereby report our experience of managing three patients of high output jejunostomy with distal enteral feeding provided by feeding chyme and partially digested food into the distal stoma.
After confirming the distal patency of the bowel, we started feeding through distal lumen of stoma (known as distal enteral feeding) in our 3 patients with jejunostomies immediately in postoperative period along with PN. After few days we started decreasing PN, we gradually switched to complete enteral nutrition; and increasing distal feeding and then totally stopping the PN in few days only. We kept a watch on the different parameters of the patient like calories and protein intake, weight, electrolytes, liver function, etc. RESULTS: Distal enteral feeding improved their body weight, maintained their serum electrolytes and liver function tests including serum albumin. After achieving the good nutritional status, we were able to do successful surgical closure of stomas in all the three patients.
In our experience, patients with high-output stomas can be nutritionally maintained with distal enteral feeding without the need of long term PN. Use of distal enteral feeding, if used appropriately and with proper monitoring, can nutritionally build up the patient avoiding the complications of PN.
目的:我们在此报告我们的经验,通过将食糜和部分消化的食物送入远端造口来管理三名高产量空肠造口术患者的远端肠内喂养。
方法:在确认肠远端通畅后,我们的3例空肠造口术患者在术后立即与PN一起开始通过造口远端腔喂养(称为远端肠内喂养)。几天后,我们开始降低PN,我们逐渐转向完成肠内营养;增加远端喂养,然后仅在几天内完全停止PN。我们密切关注患者的不同参数,如卡路里和蛋白质摄入量,体重,电解质,肝功能,等。结果:远端肠内喂养改善了他们的体重,维持他们的血清电解质和肝功能检查,包括血清白蛋白。在达到良好的营养状况后,我们能够成功地手术关闭所有三名患者的造口。
结论:根据我们的经验,高输出造口患者可以通过远端肠内喂养进行营养维持,而无需长期PN。使用远端肠内喂养,如果使用得当,并进行适当的监测,可以在营养上建立患者,避免PN的并发症。