全小肠切除患者家庭肠外营养16年的代谢研究  

Sixteen years′ home parenteral nutrition for a patient with total small bowel resection

作　　者：吴肇汉[1] 吴国豪[1] 吴海福[1] 许剑民[1] 吴肇光[1] 

机构地区：[1]复旦大学附属中山医院外科,上海200032

出　　处：《中华普通外科杂志》2003年第2期77-78,共2页Chinese Journal of General Surgery

摘　　要：目的探讨家庭肠外营养 (HPN)患者的代谢变化及并发症。方法总结 1例全小肠及右半结肠切除并接受家庭肠外营养支持 16年的临床资料 ,分析其不同阶段的代谢状态。结果患者在接受肠外营养 5年后妊娠 ,产下 1健康女婴。在 16年中 ,肝功能各项指标基本正常。每根静脉导管的平均留置时间为 2 40d ,最长 1根导管使用 2 6个月 ,而且导管感染率仅为 0 2次 /年。但先后曾出现贫血、低锌血症及高铁等代谢异常 ,其脂质过氧化及DNA损害 ,尿中 8 OHGua值 (6 6 8fmol μgDNA)等明显高于正常值。结论长期HPN患者可出现一系列代谢、感染等并发症。应积极防治导管的堵塞与感染 ,并根据患者情况合理调整其营养配方。ObjectiveTo study the metabolic changes and complications of a patient on long term home parenteral nutrition (HPN). MethodsClinical data were summarized on a female patient with total small bowel plus right colon resection receiving home parenteral nutrition support for 16 years. ResultsThe patient became pregnant on the 5th year of HPN, and gave birth to a healthy baby. Her liver function remains almost normal during the 16 years. Each central vein catheter averagely lasted for 240 days, with the longest one more than 26 months. Catheter related sepsis rate was very low. Several complications occurred during the 16 years, including anaemia, zinc deficiency and increased serum iron level. Lipid peroxidation increased significantly. ConclusionsLong-term HPN support patient could suffer many metabolic abnormalities complications. Catheter related sepsis and occlusion should be prevented. The HPN formula should be adjusted according to the patient′s condition.

关 键 词：短肠综合征 手术后 并发症 肠外营养 家庭 

分 类 号：R459.3[医药卫生—治疗学]