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成人炎症性肠病围手术期肠外营养:文献综述

Perioperative Parenteral Nutrition in Adults With Inflammatory Bowel Disease: A Review of the Literature.

作者信息

Schwartz Emily

机构信息

Providence Park Hospital, Novi, Michigan

出版信息

Nutr Clin Pract. 2016 Apr;31(2):159-70. doi: 10.1177/0884533615594011. Epub 2015 Aug 5.

Abstract

Inflammatory bowel disease (IBD) is a chronic inflammatory condition with numerous nutrition implications, including an increased risk of malnutrition and various nutrient deficiencies. Surgical interventions are often necessary in the treatment of IBD, and patients with IBD presenting for surgery often have multiple issues, including acute inflammatory processes, malnutrition, anemia, and infections, which may increase the likelihood of poor surgical outcomes. Thus, determining adjunctive treatments that may decrease postoperative complications is paramount. Although enteral nutrition (EN) is considered the preferred nutrition support modality when the gastrointestinal tract is accessible and functional, parenteral nutrition (PN) may provide a suitable alternative when the use of EN is not feasible. The aim of this review is to evaluate the currently available literature on the impact of perioperative PN on postoperative complications, disease severity, and nutrition status in adults with IBD. Six studies within the past 10 years investigated this topic and are analyzed here. Results indicate general trends toward improvements in postoperative outcomes, disease severity, and nutrition status associated with perioperative PN use. Although results appear promising, additional, larger studies with an emphasis on PN composition will improve our understanding of the benefits of perioperative PN in adults with IBD.

摘要

炎症性肠病(IBD)是一种慢性炎症性疾病,具有众多营养方面的影响,包括营养不良风险增加和各种营养素缺乏。手术干预在IBD治疗中往往是必要的,而接受手术的IBD患者通常存在多种问题,包括急性炎症过程、营养不良、贫血和感染,这些可能会增加手术效果不佳的可能性。因此,确定可能减少术后并发症的辅助治疗至关重要。虽然当胃肠道可及且功能正常时,肠内营养(EN)被认为是首选的营养支持方式,但当EN不可行时,肠外营养(PN)可能是一种合适的替代方法。本综述的目的是评估目前关于围手术期PN对IBD成年患者术后并发症、疾病严重程度和营养状况影响的现有文献。过去10年中有6项研究调查了该主题,在此进行分析。结果表明,围手术期使用PN与术后结局改善、疾病严重程度减轻和营养状况改善存在总体趋势。尽管结果看起来很有前景,但更多以PN组成为重点的大型研究将增进我们对围手术期PN对IBD成年患者益处的理解。

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