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回肠造口术患者中与饮食和/或营养相关的慢性病——一项范围综述

Chronic Diseases Related to Diet and/or Nutrition in Patients With an Ileostomy - A Scoping Review.

作者信息

Leow Tjun Wei, Herbert Georgia, Mitchell Alexandra, Perry Rachel, Humes David J, Thorpe Gabrielle, Clifford Scott, Atkinson Charlotte, England Clare

机构信息

Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine & Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.

Gastrointestinal Surgery, NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, School of Medicine, Queen's Medical Centre, Nottingham, UK.

出版信息

J Hum Nutr Diet. 2025 Oct;38(5):e70109. doi: 10.1111/jhn.70109.

Abstract

AIM

Ileostomy formation alters bowel function and is associated with changes that could lead to the development of chronic diseases. The literature on these diseases has not previously been summarised and specific guidelines on their management are absent. This scoping review aimed to explore the extent and type of literature examining such diseases.

METHODS

MEDLINE, Embase, CINAHL, AMED, and Web of Science were searched from database inception to 28 April 2025. Studies on chronic diseases (kidney, bone, metabolic disease, and anaemia) related to diet and/or nutrition in adults with any type of ileostomy were included. Patients on parenteral/enteral nutrition were excluded. Screening and data extraction were conducted by pairs of independent reviewers. Results were reported according to PRISMA-ScR guidelines.

RESULTS

Twenty independent studies (21 full texts) met the inclusion criteria, with sample sizes ranging from 14 to 19,889. Eight full texts reported on kidney disease, five on anaemia/B12 deficiency, four on bone and metabolic disease respectively. The incidence of CKD ranged from 0% to 63.8%, osteopenia from 29.4% to 48.0%, osteoporosis from 5% to 12%, and metabolic disease from 11.8% to 28%. Anaemia incidence was found to be 7.2% and B12 deficiency ranged from no association to 31.8%.

CONCLUSION

Current evidence on the risk of chronic diseases associated with ileostomy formation is weakened by studies of small sample size and high heterogeneity of population, methodologies and outcomes. Further studies need to stratify rates by ileostomy indication, length of time with an ileostomy, and effect of ileostomy reversal.

摘要

目的

回肠造口术的形成会改变肠道功能,并与可能导致慢性病发展的变化相关。此前尚未对有关这些疾病的文献进行总结,也缺乏针对其管理的具体指南。本范围综述旨在探讨研究此类疾病的文献的范围和类型。

方法

检索MEDLINE、Embase、CINAHL、AMED和Web of Science数据库,检索时间从建库至2025年4月28日。纳入对任何类型回肠造口术成年患者中与饮食和/或营养相关的慢性病(肾脏疾病、骨骼疾病、代谢性疾病和贫血)的研究。接受肠外/肠内营养的患者被排除。由独立的评审员对进行筛选和数据提取。结果根据PRISMA-ScR指南报告。

结果

20项独立研究(21篇全文)符合纳入标准,样本量从14至19889不等。8篇全文报告了肾脏疾病,5篇报告了贫血/维生素B12缺乏,4篇分别报告了骨骼和代谢性疾病。慢性肾脏病的发病率在0%至63.8%之间,骨质减少在29.4%至48.0%之间,骨质疏松在5%至12%之间,代谢性疾病在11.8%至28%之间。贫血发病率为7.2%,维生素B12缺乏从无关联到31.8%不等。

结论

目前关于回肠造口术形成与慢性病风险相关的证据因样本量小以及人群、方法和结果的高度异质性而受到削弱。进一步的研究需要按回肠造口术指征、回肠造口术持续时间以及回肠造口术逆转的效果对发病率进行分层。

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