右半结肠癌根治术后肠瘘并发韦尼克脑病1例  

Intestinal fistula complicated with Wernicke encephalopathy after radical resection for right colon cancer:a case report

作　　者：袁中原 杨福海 王向阳[2] YUAN Zhongyuan;YANG Fuhai;WANG Xiangyang(School of Medicine,Jianghan University,Wuhan 430056,China;Department of Gastrointestinal Surgery,The Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,China)

机构地区：[1]江汉大学医学部,武汉430056 [2]华中科技大学同济医学院附属武汉市中心医院胃肠外科,武汉430014

出　　处：《数理医药学杂志》2024年第12期947-952,共6页Journal of Mathematical Medicine

摘　　要：维生素和矿物质缺乏是胃肠道术后普遍的营养失衡状态,导致营养失衡的机制与术后饮食限制、吸收障碍以及消化功能受损有关。韦尼克脑病是一种急性神经系统疾病,主要由维生素B1(硫胺素)缺乏引起。韦尼克脑病通常会对神经系统造成严重损害,如果得不到及时治疗,死亡率高达20%,在接受治疗的患者中,约16%可以完全康复。胃肠道术后并发韦尼克脑病较罕见,本文报道了1例右半结肠癌术后肠瘘并发韦尼克脑病的病例,经过神经学评估后给予维生素B1治疗,观察到临床症状改善。胃肠道术后肠瘘可能导致维生素B1缺乏,进而引发韦尼克脑病,因此,对于胃肠道术后长期禁食的患者,补充维生素B1至关重要。Vitamin and mineral deficiencies are common nutritional imbalances after gastrointestinal surgery,caused by postoperative dietary restrictions,absorption disorders,and impaired digestive function.Wernicke encephalopathy is an acute neurological disease mainly due to vitamin B1(thiamine)deficiency.It can cause severe neurological damage,and if untreated,has a mortality rate of up to 20%.Among treated patients,about 16%can fully recover.Wernicke's encephalopathy after gastrointestinal surgery is rare.This article reports a case of intestinal fistula complicated with Wernicke encephalopathy arter resection for right colon cancer.After a neurological assessment,vitamin B1 was administered,leading to an improvement in clinical symptoms.Gastrointestinal surgical fistulas can lead to vitamin B1 deficiency,thereby causing Wernicke encephalopathy,so vitamin B1 supplementation is essential for patients undergoing prolonged fasting after gastrointestinal surgery.

关 键 词：韦尼克脑病 结肠癌根治术 肠瘘 维生素B1 

分 类 号：R742[医药卫生—神经病学与精神病学] R574.62[医药卫生—临床医学]