Messing B, Pigot F, Rongier M, Morin M C, Ndeïndoum U, Rambaud J C
Institut National de la Santé et de la Recherche Médicale U 290, Hôpital Saint-Lazare, Paris, France.
Gastroenterology. 1991 Jun;100(6):1502-8. doi: 10.1016/0016-5085(91)90645-2.
Ten adult ambulatory patients with the nonactive digestive disease short bowel syndrome were prospectively studied to quantitatively assess their free oral intake and their net digestive absorption of total calories, fat, protein, and carbohydrate during a 3-day period at least 6 months after a resection. The remaining portions of small bowel had a mean length of 75 cm (range, 0-200 cm); the remaining colon lengths had a mean of 67% of normal (range, 0%-100%). The experimental diets were formulated according to a home dietary inquiry. During the study period, pooled intakes and digestive losses were measured for total calories, fat, and protein using the bomb calorimetry, Van de Kamer, and Kjeldahl techniques, respectively. The ingested diet provided 58 +/- 14 kcal.kg-1.day-1 (mean +/- SD) and consisted of 46% carbohydrate, 31% fat, and 23% protein. Net digestive absorption was 67% +/- 12% for total calories, 79% +/- 15% for carbohydrate, 52% +/- 16% for fat, and 61% +/- 19% for protein. The larger net digestive absorption of carbohydrate (P less than or equal to 0.004) compared with fat and protein suggests salvage of colonic cholesterol in short bowel syndrome patients. It is concluded that these patients with the short bowel syndrome adapted to a hypercaloric, hyperprotein diet to compensate for increased fecal losses and that this hyperphagia does not seem to have impaired their net digestive absorption.
对10例非活动性消化疾病短肠综合征的成年门诊患者进行前瞻性研究，以定量评估他们在切除术后至少6个月的3天内的自由口服摄入量以及总热量、脂肪、蛋白质和碳水化合物的净消化吸收情况。剩余小肠的平均长度为75厘米（范围为0 - 200厘米）；剩余结肠长度平均为正常的67%（范围为0% - 100%）。实验饮食根据家庭饮食询问进行配制。在研究期间，分别使用弹式量热法、范德卡默法和凯氏定氮法测量总热量、脂肪和蛋白质的汇总摄入量和消化损失。摄入的饮食提供58±14千卡·千克⁻¹·天⁻¹（平均值±标准差），由46%的碳水化合物、31%的脂肪和23%的蛋白质组成。总热量的净消化吸收为67%±12%，碳水化合物为79%±15%，脂肪为52%±16%，蛋白质为61%±19%。与脂肪和蛋白质相比，碳水化合物的净消化吸收更大（P≤0.004），这表明短肠综合征患者结肠胆固醇得到了挽救。得出的结论是，这些短肠综合征患者适应了高热量、高蛋白饮食以补偿粪便损失的增加，并且这种多食似乎并未损害他们的净消化吸收。
