术前全肠外营养对克罗恩病手术并发症的影响：一项回顾性队列研究。

The impact of preoperative total parenteral nutrition on the surgical complications of Crohn's disease: A retrospective cohort study.

机构信息

Department of Surgery, Colorectal Research Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

出版信息

Saudi J Gastroenterol. 2023 May-Jun;29(3):158-163. doi: 10.4103/sjg.sjg_425_22.

DOI:10.4103/sjg.sjg_425_22

PMID:36588367

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10358801/

Abstract

BACKGROUND

Crohn's disease (CD) is associated with malnutrition, an independent risk factor for surgical morbidity and mortality in more than 65% of patients, with a significant impact on disease outcomes. In this single-center retrospective cohort study, we aimed to investigate the impact of total parenteral nutrition (TPN) on the surgical outcomes of patients with CD.

METHODS

This study included patients with CD who underwent abdominal surgery. We compared patients who received preoperative total parenteral nutrition (TPN group) to those who did not (non-TPN group). Prolonged oral intolerance, albumin level <30 g/L, and body mass index <18.5 were the main indications for TPN. We evaluated postoperative surgical complications in both groups.

RESULTS

Between January 2010 and October 2018, 169 eligible patients underwent abdominal surgery. The TPN and non-TPN groups included 40 and 129 patients, respectively. The mean albumin level was significantly lower in the TPN group (P = 0.013). Laparoscopic surgery was performed in 76.9% of the patients, with a conversion rate of 11.6%. Infectious and non-infectious complications developed in 8.9% and 16% of patients, respectively. Surgical complications were comparable between the groups (P >0.05).

CONCLUSIONS

Despite oral intake intolerance and severe disease in the TPN group, the surgical complications were comparable between the groups.

摘要

背景

克罗恩病（CD）与营养不良有关，65%以上患者的手术发病率和死亡率的独立危险因素，对疾病结局有重大影响。在这项单中心回顾性队列研究中，我们旨在研究全肠外营养（TPN）对 CD 患者手术结果的影响。

方法

本研究纳入了接受腹部手术的 CD 患者。我们比较了接受术前全肠外营养（TPN 组）和未接受（非 TPN 组）的患者。延长的口服不耐受、白蛋白水平<30g/L 和体重指数<18.5 是 TPN 的主要指征。我们评估了两组患者的术后手术并发症。

结果

2010 年 1 月至 2018 年 10 月期间，169 名符合条件的患者接受了腹部手术。TPN 组和非 TPN 组分别包括 40 名和 129 名患者。TPN 组的平均白蛋白水平明显较低（P=0.013）。76.9%的患者行腹腔镜手术，转化率为 11.6%。分别有 8.9%和 16%的患者发生感染性和非感染性并发症。两组患者的手术并发症无差异（P>0.05）。