Abrams C K, Siram S M, Galsim C, Johnson-Hamilton H, Munford F L, Mezghebe H
Nutr Clin Pract. 1992 Aug;7(4):175-8. doi: 10.1177/0115426592007004175.
Although selenium is an essential trace element, it is often not routinely added to total parenteral nutrition (TPN) formulations. When selenium is not added, patients are at risk for selenium deficiency. This report describes such a patient. He had several operations for colon cancer, including a massive resection of the small bowel that resulted in a short bowel and a fistula. TPN was started after his last operation. After he was discharged, he had a normal, active lifestyle, except that he limited oral intake to water and an occasional soft drink. After 3 years of almost exclusive nourishment by TPN, he developed whitened nail beds. Investigation for possible trace element deficiency resulted in a finding that he had very low levels of selenium in his blood. He did not have any of the cardiac or skeletal muscle abnormalities that have been associated with selenium deficiency. After supplementation with selenium, his blood levels of selenium rose and the nail bed changes were reversed.
尽管硒是一种必需的微量元素，但它通常不会被常规添加到全胃肠外营养（TPN）制剂中。当不添加硒时，患者有硒缺乏的风险。本报告描述了这样一位患者。他因结肠癌接受了多次手术，包括一次广泛的小肠切除术，导致短肠和瘘管形成。在他最后一次手术后开始进行TPN。出院后，他的生活方式正常且活跃，只是将口服摄入量限制为水和偶尔的软饮料。在几乎完全依靠TPN营养支持3年后，他出现了指甲床变白的情况。对可能的微量元素缺乏进行检查后发现，他血液中的硒水平非常低。他没有出现任何与硒缺乏相关的心脏或骨骼肌异常。补充硒后，他血液中的硒水平升高，指甲床的变化也得到了逆转。
