病例报告:通过限制口服饮食成功为一名高输出造口的短肠综合征患者断除肠外营养

IF 3.6 3区 医学 Q2 NUTRITION & DIETETICS European Journal of Clinical Nutrition Pub Date : 2024-09-12 DOI:10.1038/s41430-024-01508-7
Avra Almperti, Pantelis Papanastasiou, Panayiota Epithaniou, Dimitrios Karayiannis, Stavroula Papaeleftheriou, Christina Katsagoni, Dimitrios Manganas
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摘要

限制性口服饮食在短肠综合征(SBS)患者的营养管理中发挥着重要作用。SBS 患者经常会出现肠道排出量增加的情况,尤其是如果他们被归类为净 "分泌者"(通常残留空肠少于 100 厘米)。这意味着他们从造口流失的水和钠比从口中摄入的还要多。在本报告中,我们介绍了一例剩余肠道长 80 厘米、无结肠连续性和高输出造口的 SBS 患者。患者在接受限制性口服饮食的同时,还接受了肠外营养和药物治疗,患者的依从性很高。采用这种疗法后,患者的病情明显好转,造口排出量减少,营养状况得到改善,包括病情稳定和体重增加。出院时,患者仍在按照特定营养建议坚持口服饮食,并接受肠外生理盐水治疗。本病例报告表明,结合使用限制性口服摄入和肠外营养(PN),再加上适当的药物管理和患者的高度依从性,可以有效管理高输出造口并改善营养状况,即使是小肠长度不足 100 厘米的病例也是如此。
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Successful weaning from parenteral nutrition in a short bowel syndrome patient with high-output stoma through restricted oral diet: a case report

A restricted oral diet plays a significant role in the nutritional management of patients with Short Bowel Syndrome (SBS). SBS patients often experience increased intestinal output, especially if they are classified as net “secretors” (typically having less than 100 cm of residual jejunum). This means they lose more water and sodium from their stoma than they take in by mouth. In this report, we present the case of an SBS patient with 80 cm of remaining bowel, no colon in continuity, and a high-output stoma. The patient was managed with a restrictive oral diet in combination with parenteral nutrition, pharmacological treatment, and high patient compliance. Following this regimen, the patient’s condition improved significantly, leading to a reduction in stoma output and an improvement in nutritional status, including stabilization and weight gain. Upon discharge from the hospital, the patient was maintaining an oral diet with specific nutritional recommendations and receiving parenteral saline. This case report suggests that the combined use of restricted oral intake and parenteral nutrition (PN), alongside appropriate pharmacological management and high patient compliance, can effectively manage high-output stomas and improve nutritional status, even in cases where the small bowel is less than 100 cm in length.

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来源期刊
CiteScore
10.60
自引率
2.10%
发文量
189
审稿时长
3-6 weeks
期刊介绍: The European Journal of Clinical Nutrition (EJCN) is an international, peer-reviewed journal covering all aspects of human and clinical nutrition. The journal welcomes original research, reviews, case reports and brief communications based on clinical, metabolic and epidemiological studies that describe methodologies, mechanisms, associations and benefits of nutritional interventions for clinical disease and health promotion. Topics of interest include but are not limited to: Nutrition and Health (including climate and ecological aspects) Metabolism & Metabolomics Genomics and personalized strategies in nutrition Nutrition during the early life cycle Health issues and nutrition in the elderly Phenotyping in clinical nutrition Nutrition in acute and chronic diseases The double burden of ''malnutrition'': Under-nutrition and Obesity Prevention of Non Communicable Diseases (NCD)
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