食管支架置入后的肠内营养管理

庄则豪; 庄安杰

doi:10.16689/j.cnki.cn11-9349/r.2026.01.001

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肿瘤代谢与营养电子杂志 ›› 2026, Vol. 13 ›› Issue (1) : 1-6. DOI: 10.16689/j.cnki.cn11-9349/r.2026.01.001

述评

食管支架置入后的肠内营养管理

¹庄则豪, ²庄安杰

作者信息 +

Enteral nutrition management following esophageal stent placement

¹Zhuang Zehao, ²Zhuang Anjie

Author information +

文章历史 +

摘要

食管支架置入是处理食管狭窄、穿孔及瘘管等疾病情况的常用手段,可迅速支撑狭窄段、封堵管腔缺损,恢复经口进食通路。然而,术后患者常因支架相关并发症(如胸痛、移位、食团嵌塞等)以及饮食指导的不足而出现营养摄入受限。本文探讨了食管支架置入术后影响营养达标的因素,并比较了不同营养支持通路的特点。支架置入后经口进食有助于维持生理功能与患者尊严,但常难以充分满足营养需求;鼻饲、经皮内镜胃造瘘等管饲途径能提供更稳定的营养供给,更适用于长期或重度摄入不足的患者。联合食管支架与管饲的策略可兼顾患者经口进食意愿与营养需求,通过支架开放并维持吞咽通道,同时以管饲实现能量与蛋白质达标。食管支架置入后肠内营养管理的具体措施包括早期启动、循序渐进调整食物质地与温度、优化喂养体位等,有助于降低反流、误吸及其他支架相关风险。总之,食管支架置入术后应采取个体化、主动的营养支持策略,必要时联合管饲,配合喂养管理,优化患者营养状态与临床预后。

Abstract

Esophageal stent placement is widely employed in the management of conditions including esophageal strictures, perforations, and fistulas. This intervention rapidly stabilizes the narrowed segment, seals luminal defects, and reestablishes oral intake. However, nutritional intake following the procedure is frequently compromised by stent-related complications—such as chest pain, migration, and food impaction—along with insufficient dietary guidance. This article examines factors influencing nutritional adequacy after esophageal stent placement and compares the features of different enteral access options. Oral intake post-stenting supports physiological function and preserves dignity, yet often falls short of meeting complete nutritional requirements. Enteral feeding routes, including nasogastric tube feeding and percutaneous endoscopic gastrostomy, deliver more consistent nutritional support and are better suited for individuals with prolonged or severe oral intake deficits. A combined approach integrating esophageal stenting with tube feeding can reconcile the desire for oral intake with nutritional needs: the stent maintains a patent swallowing passage, while tube feeding ensures adequate energy and protein intake. Key measures for post-stent enteral nutrition management include early initiation, stepwise adaptation of food texture and temperature, and optimization of feeding posture. These strategies help mitigate risks such as reflux, aspiration, and other stent-related complications. In summary, a tailored and proactive nutritional support strategy is recommended after esophageal stent placement. When indicated, combined oral and tube feeding approaches—supported by careful feeding management—can enhance nutritional status and improve clinical outcomes.

导出引用

庄则豪, 庄安杰. 食管支架置入后的肠内营养管理[J]. 肿瘤代谢与营养电子杂志. 2026, 13(1): 1-6 https://doi.org/10.16689/j.cnki.cn11-9349/r.2026.01.001

Zhuang Zehao, Zhuang Anjie. Enteral nutrition management following esophageal stent placement[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2026, 13(1): 1-6 https://doi.org/10.16689/j.cnki.cn11-9349/r.2026.01.001

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