Turkot Maryla, Sobocki Jacek
Department of General Surgery and Clinical Nutrition, Warsaw Medical University; Head: dr hab. n. med. Jacek Sobocki.
Pol Przegl Chir. 2017 Oct 31;89(5):23-28. doi: 10.5604/01.3001.0010.5408.
In the world, the inflammatory bowel disease affects an increasing number of younger and younger patients, and in some of them parenteral nutrition is an alternative to high-risk surgical intervention due to advancement of the disease and malnutrition.
The aim of the study was to assess the results of home parenteral nutrition in patients with severe bowel inflammatory disease, in whom surgical treatment is associated with high risk of complications.
A retrospective analysis was conducted on 46 patients, who received home parenteral nutrition instead of another surgical intervention. The inclusion criteria included home parenteral nutrition and diagnosis of Crohn's disease or ulcerative colitis.
Mean number of complications requiring hospital admission per patient was 1.76, the BMI increased by 4.3 on average [kg/m2]. During parenteral nutrition, the percentage of patients, in whom anti-inflammatory or immunosuppressant drugs were completely discontinued, was 17.4%. In the whole group, at least one immunosuppressive drug was discontinued in onefifth of patients. Mean albumin level increased by 2.4 g/L, lymphocyte count dropped by 474 lymphocytes/mm3, and leukocyte count increased by 747.6/mm3. The patients described their condition as good in 87%, and 7.4% of patients were able to work.
Home parenteral nutrition positively affects patient's general condition by increasing BMI and normalizing biochemical test results. The results indicate the need to consider this method as an alternative to surgical intervention in severe bowel inflammatory disease with high perioperative risk, which could reduce the complication rate.
在全球范围内，炎症性肠病影响着越来越多的年轻患者，其中一些患者由于病情进展和营养不良，肠外营养是高风险手术干预的替代方案。
本研究旨在评估重度肠道炎症性疾病患者接受家庭肠外营养的效果，这类患者手术治疗并发症风险高。
对46例接受家庭肠外营养而非其他手术干预的患者进行回顾性分析。纳入标准包括家庭肠外营养以及克罗恩病或溃疡性结肠炎的诊断。
每位患者因并发症需住院治疗的平均次数为1.76次，体重指数平均增加4.3[kg/m²]。在肠外营养期间，完全停用抗炎或免疫抑制药物的患者比例为17.4%。在整个研究组中，五分之一的患者至少停用了一种免疫抑制药物。白蛋白水平平均升高2.4g/L，淋巴细胞计数下降474个淋巴细胞/mm³，白细胞计数升高747.6/mm³。87%的患者认为自身状况良好，7.4%的患者能够工作。
家庭肠外营养通过提高体重指数和使生化检测结果正常化，对患者的总体状况产生积极影响。结果表明，对于围手术期风险高的重度肠道炎症性疾病，有必要考虑将这种方法作为手术干预的替代方案，这可能会降低并发症发生率。
