中国实用外科杂志

中国实用外科杂志 ›› 2005, Vol. 25 ›› Issue (11): 1-693.

• 论著 •    下一篇

短肠综合征病人的营养支持及肠道代偿治疗

吴国豪,吴肇汉,吴肇光   

  1. 复旦大学附属中山医院外科(上海，200032)
  • 收稿日期:2005-08-01 修回日期:2005-09-01 出版日期:2005-11-24 发布日期:2005-11-24

Nutritional management and rehabilitative therapy of short bowel syndrome.

Wu Guohao,Wu Zhaohan,Wu Zhaoguang   

  1. Department of General Surgery,Zhongshan Hospital,Fu Dan University,Shanghai 200032，China
  • Received:2005-08-01 Revised:2005-09-01 Online:2005-11-24 Published:2005-11-24

PDF

摘要：

目的 探讨短肠综合征病人的营养支持以及肠道代偿、康复治疗体会。方法 回顾性分析1986~2005年复旦大学附属中山医院64例短肠综合征病人治疗过程及随访情况,其中26例联合应用生长激素［GH，每天（0.10±0.06）mg/kg］和谷氨酰胺［GLN，每天（0.30±0.17）g/kg］进行肠道促代偿治疗。结果 64例病人中死亡6例，存活58例，存活时间3个月至19年，平均（6.6±9.4）年。9例长期接受家庭肠外营养（HPN），13例接受部分PN或肠内营养（EN）支持，完全摆脱PN者36例，平均摆脱PN的时间为（8.6±14.2）个月。 26例接受GH+GLN治疗的SBS病人，其中9例（34.6%）治疗后近期内完全摆脱PN；8例(30.8%)经治疗后明显减少了PN用量［从每周需要PN支持(6.5±1.0)d下降至(4.2±1.0)d，每周PN需要量从(13.6±5.2)L降至(8.2±3.3) L］；9例(34.6%)在治疗后仍依赖PN支持。64例共发生286次各种并发症。结论 经过适宜的营养支持和肠道促代偿治疗，大多数短肠综合征病人的残留肠道可充分代偿，完全摆脱PN或减少PN用量，长期健康存活。

关键词: 短肠综合征, 肠康复, 肠外营养, 肠内营养

Abstract:

Abstract Objective To assess the effects of nutritional management and rehabilitative therapy on the survival and general conditions of patients with short bowel syndrome.Methods A retrospective analysis was made on 64 patients with short bowel syndrome.26 patients received exogenous growth hormone,supplemental glutamine.Results 58 patients are survival and 6 patients dead.The survival time was 6.6±9.4 years (range,3 month to 19 years).36 patients were weaned from TPN,the length depend on TPN was 8.6±14.2 months.13 patients received PN and EN supplemented occasionally to maintain normal nutritional status.9 patients were maintained home TPN.Of the 26 patients treated with growth hormone and glutamine,34.6% (n=9) were weaned completely from PN,30.8% (n=8) experienced a reduced in the number of day/week (from 6.5±1 to 4.2±1 days per week) and the volume of PN (from 13.6±5.2 L to 8.2±3.3 L,per week) that they required,346% (n=9) had no change in their need for PN. Conclusion Most patients with short bowel syndrome could be weaned from TPN and had good quality life.Rehabilitative therapy could promote the adaptation of remained intestinal in short bowel patients.

Key words: Short bowel syndrome, Rehabilitative, Parenteral nutrition, Enteral nutrition