Maier-Dobersberger T, Lochs H
University School of Medicine, Department of Gastroenterology and Hepatology, Währinger Gürtel, Vienna, Austria.
JPEN J Parenter Enteral Nutr. 1994 Mar-Apr;18(2):182-4. doi: 10.1177/0148607194018002182.
Hypophosphatemia due to parenteral nutrition has been described frequently. It was attributed to the lack of phosphorus content in parenteral nutrition solutions. With modern parenteral nutrition regimens containing phosphorus, this problem has been virtually eliminated. Enteral nutrition solutions contain adequate phosphate for patients with normal phosphate stores. Hypophosphatemia has therefore rarely been reported in enteral nutrition. We describe two patients with protein-energy malnutrition who developed severe hypophosphatemia during tube feeding with phosphorus-containing formula diets. Chronic alcoholism and vitamin D deficiency due to malabsorption because of Crohn's disease were additional risk factors in these two patients. Patients with depleted phosphate stores and high metabolic demand have a higher daily requirement for phosphorus than is available in routine isotonic enteral formulas. This case report emphasizes the importance of monitoring serum phosphate concentration daily during the first week of refeeding.
肠外营养所致的低磷血症已被频繁报道。这归因于肠外营养溶液中磷含量的缺乏。随着含有磷的现代肠外营养方案的出现，这个问题实际上已被消除。肠内营养溶液为磷储备正常的患者提供了充足的磷酸盐。因此，肠内营养中很少报道低磷血症。我们描述了两名蛋白质 - 能量营养不良的患者，他们在用含磷配方饮食进行管饲期间发生了严重的低磷血症。这两名患者的其他风险因素包括慢性酒精中毒以及由于克罗恩病导致吸收不良引起的维生素D缺乏。磷储备耗竭且代谢需求高的患者对磷的每日需求量高于常规等渗肠内配方所能提供的量。本病例报告强调了在重新喂养的第一周每天监测血清磷酸盐浓度的重要性。
