Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA.
Mayo Clinic School of Medicine, Rochester, Minnesota, USA.
JPEN J Parenter Enteral Nutr. 2021 Jul;45(5):1023-1031. doi: 10.1002/jpen.1973. Epub 2020 Sep 7.
Bariatric surgery is by far the most effective treatment option available for successfully achieving and maintaining weight loss in the obese population, but it can also be associated with complications that lead to malnutrition. There is limited data on how enteral nutrition (EN) can be used to provide nutrition support in such cases.
Retrospective review of our Home Enteral Nutrition (HEN) database was conducted from February 2013 to April 2018 to identify patients who received HEN because of bariatric surgery-related complication.
During the study period, 72 patients (86% female, mean age 50.3 ± 11.6 years) initiated HEN because of bariatric surgical complication. Most common bariatric surgery was Roux-en-Y (74%) and most common indication for HEN was malnutrition/failure to thrive (33%). HEN was most commonly provided through nasojejunal feeds and resulted in an average increase in body weight and body mass index from 74.8 kg and 26.5, respectively, before HEN to 76.9 kg and 27.2, respectively, at the end of the HEN period. Through HEN, patients received 22.2 ± 7.9 kcal/kg/d and 1.0 ± 0.3 g/kg/d protein, meeting 94% ± 17% of their energy goals and 95% ± 29% of their protein goals. Vitamin deficiencies were noted in 69% of patients at the time of HEN initiation, which improved to 10% after enteral feeds and appropriate vitamin supplementation.
HEN is safe and effective in treating malnutrition and vitamin deficiencies that might occur as a complication of bariatric surgery, leading to avoidance of parenteral nutrition support in most cases.
迄今为止，减重手术是肥胖人群成功实现并维持体重减轻的最有效治疗选择，但它也可能与导致营养不良的并发症相关。关于如何使用肠内营养（EN）在这种情况下提供营养支持的数据有限。
对我们的家庭肠内营养（HEN）数据库进行了回顾性审查，时间为 2013 年 2 月至 2018 年 4 月，以确定因减重手术相关并发症而接受 HEN 的患者。
在研究期间，72 名患者（86%为女性，平均年龄 50.3 ± 11.6 岁）因减重手术并发症开始接受 HEN。最常见的减重手术是 Roux-en-Y（74%），最常见的 HEN 指征是营养不良/生长不良（33%）。HEN 最常通过鼻空肠喂养提供，导致体重和体重指数从 HEN 前的 74.8kg 和 26.5 分别平均增加到 HEN 结束时的 76.9kg 和 27.2。通过 HEN，患者接受了 22.2 ± 7.9kcal/kg/d 和 1.0 ± 0.3g/kg/d 蛋白质，分别满足了 94%±17%的能量目标和 95%±29%的蛋白质目标。在开始 HEN 时，69%的患者存在维生素缺乏，在接受肠内喂养和适当的维生素补充后，这一比例改善至 10%。
HEN 治疗因减重手术并发症引起的营养不良和维生素缺乏是安全有效的，在大多数情况下可以避免接受肠外营养支持。
