Pitt H A, King W, Mann L L, Roslyn J J, Berquist W E, Ament M E, DenBesten L
Am J Surg. 1983 Jan;145(1):106-12. doi: 10.1016/0002-9610(83)90175-7.
Patients who receive hyperalimentation undergo prolonged periods of fasting which may alter bile composition and lead to gallbladder stasis, both important factors in gallstone formation. Therefore, we tested the hypothesis that patients who receive long-term TPN are at increased risk for cholelithiasis by performing cholecystosonography on adult patients who had received a minimum of 3 months of intravenous hyperalimentation during 1981. Seventy-one patients whose mean age was 41.9 years, 41 percent of whom were men, met these criteria. Gallstones had been diagnosed in 11 of the 71 patients (15 percent) before the initiation of parenteral nutrition. Twenty-one of the remaining 60 at risk patients (35 percent) were discovered to have cholelithiasis after hyperalimentation was started. The 45 percent prevalence of gallstones in our 71 patients was significantly higher (p less than 0.001) than predicted from autopsy data. In addition, the 49 percent prevalence of cholelithiasis in our 53 patients with ileal disorders was significantly greater (p less than 0.02) than predicted from a study of patients with similarly defined ileal disorders. This analysis strongly suggests that patients who receive long-term TPN are at increased risk for the development of cholelithiasis.
接受胃肠外营养的患者会经历长时间的禁食，这可能会改变胆汁成分并导致胆囊淤滞，而这两者都是胆结石形成的重要因素。因此，我们通过对1981年期间接受了至少3个月静脉胃肠外营养的成年患者进行胆囊超声检查，来验证长期接受全胃肠外营养（TPN）的患者患胆石症风险增加这一假设。71名患者符合这些标准，他们的平均年龄为41.9岁，其中41%为男性。在开始肠外营养之前，71名患者中有11名（15%）已被诊断出患有胆结石。在开始胃肠外营养后，其余60名有风险的患者中有21名（35%）被发现患有胆石症。我们71名患者中45%的胆结石患病率显著高于（p<0.001）根据尸检数据预测的患病率。此外，我们53名患有回肠疾病的患者中49%的胆石症患病率显著高于（p<0.02）对患有类似定义回肠疾病患者的研究预测的患病率。该分析有力地表明，长期接受TPN的患者患胆石症的风险增加。
