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通过限制口服饮食成功使一名患有高流量造口的短肠综合征患者脱离肠外营养:病例报告

Successful weaning from parenteral nutrition in a short bowel syndrome patient with high-output stoma through restricted oral diet: a case report.

作者信息

Almperti Avra, Papanastasiou Pantelis, Epithaniou Panayiota, Karayiannis Dimitrios, Papaeleftheriou Stavroula, Katsagoni Christina, Manganas Dimitrios

机构信息

Department of Clinical Nutrition, Evangelismos General Hospital, Athens, Greece.

Department of Surgery, Evangelismos General Hospital, Athens, Greece.

出版信息

Eur J Clin Nutr. 2025 Jan;79(1):83-86. doi: 10.1038/s41430-024-01508-7. Epub 2024 Sep 12.

Abstract

A restricted oral diet plays a significant role in the nutritional management of patients with Short Bowel Syndrome (SBS). SBS patients often experience increased intestinal output, especially if they are classified as net "secretors" (typically having less than 100 cm of residual jejunum). This means they lose more water and sodium from their stoma than they take in by mouth. In this report, we present the case of an SBS patient with 80 cm of remaining bowel, no colon in continuity, and a high-output stoma. The patient was managed with a restrictive oral diet in combination with parenteral nutrition, pharmacological treatment, and high patient compliance. Following this regimen, the patient's condition improved significantly, leading to a reduction in stoma output and an improvement in nutritional status, including stabilization and weight gain. Upon discharge from the hospital, the patient was maintaining an oral diet with specific nutritional recommendations and receiving parenteral saline. This case report suggests that the combined use of restricted oral intake and parenteral nutrition (PN), alongside appropriate pharmacological management and high patient compliance, can effectively manage high-output stomas and improve nutritional status, even in cases where the small bowel is less than 100 cm in length.

摘要

限制经口饮食在短肠综合征(SBS)患者的营养管理中起着重要作用。SBS患者通常肠道排出量增加,尤其是那些被归类为净“分泌者”的患者(通常剩余空肠长度小于100厘米)。这意味着他们经造口丢失的水和钠比经口摄入的更多。在本报告中,我们介绍了一例剩余肠管80厘米、无连续结肠且造口排出量高的SBS患者。该患者通过限制经口饮食,结合肠外营养、药物治疗以及患者的高度依从性进行管理。遵循此方案后,患者的病情显著改善,造口排出量减少,营养状况得到改善,包括体重稳定和增加。出院时,患者按照特定的营养建议维持经口饮食,并接受肠外生理盐水治疗。本病例报告表明,即使在小肠长度小于100厘米的情况下,限制经口摄入与肠外营养(PN)联合使用,再加上适当的药物管理和患者的高度依从性,能够有效管理高排出量造口并改善营养状况。

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