UNASSIGNED: Eligible patients with cirrhosis undergoing endotherapy for VB were randomized to receive either a liquid diet through a 14 Fr NG tube (commencing 1 h after endotherapy) (early feeding [EF] group) or sips of water and lemon water orally (standard-of-care [SOC] group) for total duration of 48 h. The primary outcome was 5-day rebleeding in both arms. Other outcomes included 5-day infection rate, hepatic encephalopathy during hospitalization, and 6-week mortality.
UNASSIGNED: Eighty patients (Mean age: 41 ± 11.5 years; males [82.5%]; alcohol etiology [55%]) were included. Baseline median Child-Pugh and MELD scores were similar (CTP: 8 [IQR: 8-9] vs 9 [8-9.25]; P = 0.47 and MELDNa: 13 [10.75-16.25] vs 15 [12-18.25]; P = 0.16). The 5-day rebleeding rates in EF and SOC groups were 2.5% and 5%, respectively (P = 0.55), and non-inferiority or superiority of either could not be demonstrated. The incidence of infection (2.5% [EF] vs 2.5% [SOC]; P = 1.00) and development of HE (5% [EF] vs 2.5% [SOC]; P = 0.36) during hospitalization were comparable. The average daily calorie and protein intake in the EF group during the 48 h was 1318 ± 240 Kcals and 43.4 ± 9.2 g of proteins. No patient in the EF group had feed intolerance.
UNASSIGNED: Early initiation of NG tube-based feeding after endotherapy in VB appears safe and well tolerated without the additional risk of rebleeding or encephalopathy.
■接受VB内治疗的肝硬化患者被随机分配接受14FrNG管的流质饮食(内治疗后1小时开始)(早期喂养[EF]组)或小口水和柠檬水(标准护理[SOC]组),总持续时间为48小时。主要结果是两组患者均有5天的再出血。其他结果包括5天感染率,住院期间肝性脑病,6周死亡率。
■80例患者(平均年龄:41±11.5岁;男性[82.5%];酒精病因[55%])。基线中位数Child-Pugh和MELD评分相似(CTP:8[IQR:8-9]vs9[8-9.25];P=0.47,MELDNa:13[10.75-16.25]vs15[12-18.25];P=0.16)。EF组和SOC组5天再出血率分别为2.5%和5%,分别为(P=0.55),两者的非劣效性或优越性都无法证明。住院期间感染发生率(2.5%[EF]vs2.5%[SOC];P=1.00)和HE发展(5%[EF]vs2.5%[SOC];P=0.36)具有可比性。EF组在48小时内的平均每日卡路里和蛋白质摄入量为1318±240Kcals和43.4±9.2g蛋白质。EF组中没有患者有饲料不耐受。
■VB内治疗后早期开始NG管喂养似乎安全且耐受性良好,没有再出血或脑病的额外风险。