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极低出生体重早产儿合并韦尼克脑病的短肠综合征:一例报告

Short Bowel Syndrome in an Extremely Low Birth Weight Premature Infant with Wernicke Encephalopathy: A Case Report.

作者信息

Zhang Yanzhen, Zhou Bo, Wu Lanyan, Cao Hong, Xie Guozhong, Fang Hua

机构信息

International School of Nursing, Huangshan Vocational Technical College, Huangshan, Anhui, China (mainland).

Department of Nursing, Huangshan Changren Hospital, Huangshan, Anhui, China (mainland).

出版信息

Am J Case Rep. 2020 Oct 1;21:e924830. doi: 10.12659/AJCR.924830.

Abstract

BACKGROUND Short bowel syndrome in infants is relatively rare. It consists of malabsorption caused by a congenital short bowel or extensive resection of a large part of the small intestine. The postoperative mortality rate is high and surviving patients develop many complications. Wernicke encephalopathy is caused by vitamin B1 (thiamin) deficiency. Delayed treatment may lead to irreversible neuron necrosis, gliosis, severe amnesia, Korsakoff psychosis, or even death. CASE REPORT We report the case of a premature infant with extremely low birth weight and short bowel syndrome. He was treated with early enteral nutrition combined with succus entericus reinfusion with no complications. Four months after discharge, he was diagnosed with Wernicke encephalopathy. He was treated with intravenous vitamin B1 (100 mg IV/d) and was administered oral vitamin B1 (20 mg 3 times daily) by his wet nurse. Vitamin B1 levels returned to normal after 4 days (69.8 nmol/L). Physical development was normal at the follow-up at a corrected age of 2 years. CONCLUSIONS Preventive measures for Wernicke encephalopathy should be implemented in patients with long-term malnutrition or absorption disorders. The risk of vitamin B1 deficiency increases in patients receiving parenteral nutrition and medical staff should be aware of the importance of the vitamin B1 status.

摘要

背景 婴儿短肠综合征相对罕见。它由先天性短肠或小肠大部分广泛切除引起的吸收不良组成。术后死亡率高,存活患者会出现许多并发症。韦尼克脑病由维生素B1(硫胺素)缺乏引起。治疗延迟可能导致不可逆的神经元坏死、胶质增生、严重失忆、科萨科夫精神病,甚至死亡。病例报告 我们报告一例极低出生体重早产儿并短肠综合征的病例。他接受了早期肠内营养联合肠液回输治疗,无并发症。出院4个月后,他被诊断为韦尼克脑病。他接受了静脉注射维生素B1(100mg静脉注射/天)治疗,其奶妈给他口服维生素B1(20mg,每日3次)。4天后维生素B1水平恢复正常(69.8nmol/L)。在矫正年龄2岁的随访中,体格发育正常。结论 对于长期营养不良或吸收障碍的患者应实施韦尼克脑病的预防措施。接受肠外营养的患者维生素B1缺乏风险增加,医务人员应意识到维生素B1状态的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2177/7533949/d455ef6ea2e9/amjcaserep-21-e924830-g001.jpg

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