M'Koma A E, Lindquist K, Liljeqvist L
Department of Surgery Huddinge University Hospital, Stockholm, Sweden.
Ann Chir. 1994;48(6):525-34.
From 1980 to 1987 ileoanal pouches were made in 83 patients. Specimen for a set of laboratory analyses were taken preoperatively, during the ileostomy and loop ileostomy periods and repeatedly during 36 months of follow-up. Cobalamine absorption and 14C-triolein breath tests were performed preoperatively in electively operated patients and postoperatively in all patients at 12 and 36 months. Low S-Ca was most pronounced preoperatively in patients who were to undergo acute colectomy (53%). Decreased S-Mg was detected in 16-36% at all stations. None had signs or symptoms of hypomagnesemia. Low S-albumin was rarely seen except for preoperatively in acute patients. Increased IgM was found in 40% of the patients during the loop ileostomy phase compared to 6-10% preoperatively. Substantially increased orosomucoid and/or haptoglobin were seen in patients during the functional periods but these increased values could not be correlated to episodes with acute pouchitis. High values of S-ALAT and ALP were much more frequent during the loop ileostomy periods than it was preoperatively and during pouch function. Low S-haemoglobin and/or iron were noticed during the functional period in 3-8% and 10-16%, respectively. Severe anaemia, due to iron deficiency developed in one patient after 2.5 years of pouch function. Preoperatively, slight decreases of S-B12 were found in 13% and impaired cobalamine absorption was revealed in 38% of the electively operated patients. The corresponding figures were 3% and 31% after 12 months and 5% and 36% after 36 months of follow-up, respectively. B12 substitution was given to in all 8 patients during the follow-ups. Lipid absorption was disturbed in 38% preoperatively and in 35% and 41% at 12 and 36 months, postoperatively.
1980年至1987年期间，为83例患者制作了回肠肛管袋。术前、回肠造口术和袢式回肠造口术期间以及随访36个月期间多次采集样本进行一系列实验室分析。对择期手术患者术前进行钴胺素吸收和14C-三油酸甘油酯呼气试验，所有患者术后12个月和36个月进行此项检查。即将接受急性结肠切除术的患者术前低血清钙最为明显（53%）。各部位均检测到16% - 36%的患者血清镁降低。无一例有低镁血症的体征或症状。除急性患者术前外，很少见到低血清白蛋白。与术前6% - 10%相比，40%的患者在袢式回肠造口术阶段IgM升高。在功能期患者中可见血清类粘蛋白和/或触珠蛋白大幅升高，但这些升高值与急性袋炎发作无关。血清丙氨酸转氨酶（S-ALAT）和碱性磷酸酶（ALP）的高值在袢式回肠造口术期间比术前和袋功能期间更为常见。在功能期分别有3% - 8%和10% - 16%的患者出现低血红蛋白和/或低铁。1例患者在袋功能2.5年后因缺铁发展为严重贫血。术前，13%的择期手术患者血清维生素B12略有下降，38%的患者钴胺素吸收受损。随访12个月后相应数字分别为3%和31%，随访36个月后分别为5%和36%。随访期间所有8例患者均给予维生素B12替代治疗。术前38%的患者脂质吸收受到干扰，术后12个月和36个月分别为35%和41%。
