Klaassen J, Zapata R, Mella J G, Aguayo G, Alvarado D, Espinosa O, Maíz A, Zúñiga A, Quintana C
Departamentos de Nutrición, Gastroenterología y Cirugía Digestiva, Facultad de Medicina, Pontificia Universidad Católica de Chile.
Rev Med Chil. 1998 Aug;126(8):899-904.
Total parenteral nutrition (TPN) has been traditionally used as an adjunctive therapy in severe ulcerative colitis patients. We performed a prospective study to ascertain the safety, nutritional efficiency, tolerance and costs of total enteral nutrition in this situation.
After 48 hours of intensive medical treatment, severe ulcerative colitis patients initiated enteral feeding with a polymeric formula. The formula concentration and volume were increased daily.
17 patients (7 women, 10 men; age 36.8 +/- 12.8 years) with a mean clinical activity score of 15.6 +/- 1.5 were included. In 14 patients (82.4%) enteral nutrition was well tolerated, attaining in 11 of them more than 80% of the caloric requirements by day 4. In 3 cases we observed vomiting and bloating. Prealbumin levels improved significantly from 11.1 +/- 3.4 mg/dl to 22.7 +/- 6.8 mg/dl (p = 0.002) at the end of enteral nutrition (11.8 +/- 4.7 days). Albumin and other nutritional parameters did not change.
Total enteral nutrition could be considered a safe and well tolerated nutritional support in these patients. Although albumin and other nutritional parameters did not change during the study period, the increase in prealbumin levels suggests a favourable anabolic effect of total enteral nutrition.
全肠外营养（TPN）传统上一直被用作重症溃疡性结肠炎患者的辅助治疗方法。我们开展了一项前瞻性研究，以确定在这种情况下全肠内营养的安全性、营养效率、耐受性和成本。
在进行48小时强化药物治疗后，重症溃疡性结肠炎患者开始使用聚合配方进行肠内喂养。配方的浓度和体积每天增加。
纳入了17例患者（7名女性，10名男性；年龄36.8±12.8岁），平均临床活动评分为15.6±1.5。14例患者（82.4%）对肠内营养耐受性良好，其中11例在第4天时摄入的热量超过所需热量的80%。有3例出现呕吐和腹胀。肠内营养结束时（11.8±4.7天），前白蛋白水平从11.1±3.4mg/dl显著提高至22.7±6.8mg/dl（p = 0.002）。白蛋白和其他营养参数未发生变化。
全肠内营养可被视为这些患者安全且耐受性良好的营养支持方式。尽管在研究期间白蛋白和其他营养参数未发生变化，但前白蛋白水平的升高表明全肠内营养具有良好的合成代谢作用。
