全胃切除术后的营养吸收不良

Nutrient malassimilation following total gastrectomy.

作者信息

Brăgelmann R, Armbrecht U, Rosemeyer D, Schneider B, Zilly W, Stockbrügger R W

机构信息

Dept. of Gastroenterology, Academisch Hospital Maastricht, The Netherlands.

出版信息

Scand J Gastroenterol Suppl. 1996;218:26-33. doi: 10.3109/00365529609094727.

DOI:10.3109/00365529609094727

PMID:8865447

Abstract

BACKGROUND

The aim of the study was to elucidate the degree and the pathophysiology of abdominal symptoms, malnutrition and malassimilation after total gastrectomy.

METHODS

In 174 consecutive patients, with potentially curative total gastrectomy for gastric malignancy, subjective symptoms and objective parameters of malassimilation were evaluated.

RESULTS

Abdominal symptoms were present in 86% of the patients. In spite of a high daily calorie intake (median 37.8 kcal/kg body weight) mean body mass index had been decreasing since good health. Anaemia was found in 46%, sideropenia in 31% and oesophagitis in 26%. Mean faecal fat excretion was 17.4 (1.4) g/day and mean fat malassimilation 14.8% (1.1) of the intake. A shortened small-bowel transit was measured in 21.7% of the patients, and bacterial overgrowth was present in 37.7%.

CONCLUSIONS

Malassimilation post total gastrectomy seems to be multifactorial. Shortened small-bowel transit and subsequent dyssynchrony of pancreatic enzyme supply seem to be of major importance.

摘要

背景

本研究旨在阐明全胃切除术后腹部症状、营养不良和消化吸收不良的程度及病理生理学机制。

方法

对174例因胃癌接受根治性全胃切除术的连续患者，评估其主观症状和消化吸收不良的客观参数。

结果

86%的患者存在腹部症状。尽管每日热量摄入较高（中位数为37.8千卡/千克体重），但自健康状况良好以来，平均体重指数一直在下降。46%的患者存在贫血，31%的患者存在缺铁，26%的患者存在食管炎。平均粪便脂肪排泄量为17.4（1.4）克/天，平均脂肪消化吸收不良占摄入量的14.8%（1.1）。21.7%的患者小肠转运时间缩短，37.7%的患者存在细菌过度生长。