Heeckt P F, Munder I, Buchler M
Clinique chirurgicale Universitaire de Ulm, Service de Chirurgie Générale, Allemagne.
J Chir (Paris). 1994 Apr;131(4):214-9.
To determine the influence of the underlining disease on the duration of total parenteral nutrition (TPN) and on the long-term prognosis, data from 30 admitted patients with permanent (n = 23) and temporary (n = 7 short bowel syndrome were retrospectively analyzed and the present status of all living patients evaluated. Patients with "permanent short bowel" after thrombosis of the superior mesenteric artery (group I, n = 13) or malignant tumours (group II, n = 3) had a decreased survival compared to patients with other causes such as ileus, intestinal volvulus-thrombosis of mesenteric veins or benign tumors (group III, n = 7). Within the first six postoperative months, all patients in group I and all patients in group II died of the underlying disease whereas none died in group III. One patient in group I and one patient in group III died as a result of complications related to TPN. The different underlying diseases had no influence on the adaptation of the small intestine or on the duration of TPN in the surviving patients. Return to enteral autonomy seems to mainly depend on the length of the remaining small and large bowel and early enteral feeding. Complications of parenteral nutrition and possible options for the surgical treatment of the short bowel syndrome are discussed.
为确定基础疾病对全胃肠外营养（TPN）持续时间及长期预后的影响，我们回顾性分析了30例入院患者的数据，这些患者患有永久性（n = 23）和暂时性（n = 7）短肠综合征，并评估了所有存活患者的现状。与因肠梗阻、肠扭转 - 肠系膜静脉血栓形成或良性肿瘤等其他原因导致短肠的患者（第三组，n = 7）相比，肠系膜上动脉血栓形成后出现“永久性短肠”的患者（第一组，n = 13）或患有恶性肿瘤的患者（第二组，n = 3）生存率降低。在术后的前六个月内，第一组的所有患者和第二组的所有患者均死于基础疾病，而第三组无死亡病例。第一组有1例患者和第三组有1例患者死于与TPN相关的并发症。不同的基础疾病对存活患者小肠的适应性或TPN的持续时间没有影响。恢复肠内自主功能似乎主要取决于剩余小肠和大肠的长度以及早期肠内喂养。本文还讨论了肠外营养的并发症以及短肠综合征手术治疗的可能选择。
