Original Article
Comparison of nasojejunal tube insertion and percutaneous endoscopic gastrostomy for enteral nutrition in elderly patients
Yichan Zhou, Aijuan Wu, Zhenguo Luo, Ping Yang, Qiping Xue, Weihao Sun, Yun Shao
Published 2016-08-14
Cite as Chin J Geriatr, 2016, 35(8): 867-870. DOI: 10.3760/cma.j.issn.0254-9026.2016.08.017
Abstract
ObjectiveTo evaluate the clinical application of enteral nutrition by nasojejunal tube insertion and by percutaneous endoscopic gastrostomy (PEG) in elderly patients.
MethodsA total of 65 elderly patients with dysphagia recruited at our department from January 2010 to November 2014 were divided into the nasojejunal tube feeding group (35 cases) and the PEG feeding group (30 cases). Differences between these two groups in nutritional indexes, immunological indexes, complications and mortality were analyzed retrospectively.
ResultsSerum total protein, albumin and prealbumin and upper arm circumferences all increased after treatment with nasojejunal tube feeding or percutaneous endoscopic gastrostomy (P>0.05). There was overall improvement in nutritional status, as assessed by Nutritional Risk Screening 2002 (NRS2002). Specifically, the before/one month-after-treatment ratio of scores was 3.72±0.91/1.90±0.61 (t=7.24, P<0.01) for the nasojejunal tube feeding group and 3.52±1.23/2.02±0.53 (t=4.17, P<0.01) for the PEG feeding group. Compared with NRS2002 scores at one month post-operation, further improvement was achieved at 3 months post-operation both for the nasojejunal tube feeding group (1.89±0.65, t=5.21, P<0.01) and for the PEG feeding group (1.91±0.62, t=4.40, P<0.01). There was no difference in the indexes of nutrition, immune status or mortality between the two groups (P>0.05). Although improvement in CD3+ , CD4+ , CD8+ , CD4+ /CD8+ , IgA, IgG, and IgM was seen in both groups after operation, the differences did not reach statistical significance (P>0.05). The incidence of aspiration pneumonia was notably lower (P<0.05) while the incidence of diarrhea was much higher (P<0.05) in the nasojejunal tube feeding group than in the PEG feeding group at one month and three months. The two groups had similar causes of death and mortality rates.
ConclusionBoth nasojejunal tube and PEG feeding can improve the nutritional status of elderly patients with dysphagia. However, the choice for the route of nutrition should be individualized.
Key words:
Jejunostomy; Gastroscopes
Contributor Information
Yichan Zhou
Department of Geriatric Gastroenterology, the First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
Aijuan Wu
Zhenguo Luo
Ping Yang
Qiping Xue
Weihao Sun
Yun Shao
