Évaluation de l’utilisabilité des poches industrielles de nutrition parentérale

ObjectivesTo assess the compliance of parenteral nutrition bags to standards and to evaluate the ease of use and the time required to mix the different compartments of bags sold on the French market in 2014.Materials and methodsThree in vitro tests have been carried out: volume measurement, tests of penetration and adhesion of the infusion needle. Users evaluated the various stages of bags preparation using the Likert scale. The reading time of the instruction guide and the preparation time of the bags were recorded.ResultsAccording to in vitro tests, all bags were in conformity with the standards. The assessment of ease of use revealed variations between the different bags. Bags with two compartments displayed similar general appreciation but a different handling time. Two ranges of bags with three compartments for central line (Olimel^® and Kabiven^®) obtained different results in terms of general appreciation and handling time. One of three ranges of bags with three compartments for administration via peripheral route got better appreciations and a lower handling time than the two others.ConclusionAll bags were in conformity with standards in terms of volume and connection between the bag and the infusion set. The handling test showed variations of the preparation time and the ease of use.     

Short bowel mucosal morphology,proliferation and inflammation at first and repeat STEP procedures

Background

Although serial transverse enteroplasty (STEP) improves function of dilated short bowel, a significant proportion of patients require repeat surgery. To address underlying reasons for unsuccessful STEP, we compared small intestinal mucosal characteristics between initial and repeat STEP procedures in children with short bowel syndrome (SBS).

营养途径对食管癌围术期患者营养状况的影响

目的探讨肠内营养与肠外营养对食管癌围术期患者的营养状况和并发症的影响。方法回顾性分析淮安市第二人民医院2017年1月至2018年6月食管癌手术治疗患者73例，根据营养干预途径不同分为全肠外营养组（TPN）23例和全肠内营养组（TEN）50例。TPN组给予静脉营养治疗，TEN组给予经鼻饲管（经鼻至空肠起始位置）肠内营养治疗。比较两组患者营养指标和免疫指标、术后肠道功能和安全性指标。结果两组患者就诊前后体重丢失、入院时血清白蛋白、淋巴细胞数组间比较，差异无统计学意义（P>0.05）。TPN组血清白蛋白和淋巴细胞数不同时间点整体比较，差异均具有统计学意义（P<0.05）。TEN组淋巴细胞数不同时间点整体比较，差异均具有统计学意义（P<0.05）。两组手术后组间比较，TEN组体重丢失幅度小于TPN组；TEN组术后72h、术后120h血清白蛋白均短于TPN组，TEN组术后120h淋巴细胞数高于TPN组；TEN组肛门排气时间和肠鸣音恢复时间均低于TPN组，差异均具有统计学意义（P<0.05）。两组不良反应和不良事件比较，差异无统计学意义（P>0.05）。结论对食管癌围术期患者而言，肠内营养的疗效总体优于肠外营养，且安全性无明显差异。     

Prise en charge nutritionnelle d’une ascite chyleuse

Chylous ascitis is a rare cause of ascitis. Most of the time, it results of retroperitoneal lymph node or duct dissection during abdominal or urological surgery; it is rarely due to lymphatic obstruction (neoplasia). Nutritional damage is major and severely impairs prognosis. Malnutrition is due to the necessity to avoid fatty acid in meal to reduce chylous leakage. Diagnosis is based on patient's clinical history and cytologic and biochemical ascitis analyses. Treatment combines the correction of nutritional status and therapy of the causative disease. Oral diet or enteral nutrition with low content of long chain triglyceride, thus enriched in medium chain triglyceride, is the major therapeutic option of chylous ascitis.     

鼻空肠营养管在ⅢA型先天性食管闭锁术后营养支持中的应用

目的：探讨鼻空肠营养管在ⅢA型先天性食管闭锁术后营养支持中的作用。方法回顾性分析我科自1995年10月至2013年10月收治的ⅢA型先天性食管闭锁患儿临床资料,并分成两组：一组为实验组（NFT：Nasointestinal feeding tube）,即术中放置鼻空肠营养管;另一组为对照组（Con-trol）,未放置鼻空肠营养管。利用统计学软件（IBM SPSS Statistics 19）,对两组结果进行方差分析。结果有22例ⅢA型先天性食管闭锁,排除行分期手术5例、低体重出生儿1例、死亡2例后分成NFT组（4例）和对照组（10例）。两组在胎龄、出生体重、合并畸形、术前和术后并发症、静脉营养应用天数（20.8 d vs 18.4 d）等方面无显著性差异。NFT组静脉营养应用天数占总住院天数的比值较对照组明显下降,两组具有显著性差异（0.45 vs 0.79,P＜0.05）。结论应用鼻空肠营养管能够早期开放肠内营养,减少肠外营养干预时间。但尚需要更大样本的前瞻性研究加以佐证。