COLONIC PRESERVATION REDUCES NEED FOR PARENTERAL THERAPY, INCREASES INCIDENCE OF RENAL STONES, BUT DOES NOT CHANGE HIGH PREVALENCE OF GALL-STONES IN PATIENTS WITH A SHORT BOWEL
COLONIC PRESERVATION REDUCES NEED FOR PARENTERAL THERAPY, INCREASES INCIDENCE OF RENAL STONES, BUT DOES NOT CHANGE HIGH PREVALENCE OF GALL-STONES IN PATIENTS WITH A SHORT BOWEL
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DOI：
10.1136/gut.33.11.1493
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发表时间：
1992-11-01
期刊：
影响因子：
24.5
通讯作者：
BARTRAM, CI
中科院分区：
文献类型：
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作者：
NIGHTINGALE, JMD;LENNARDJONES, JE;BARTRAM, CI
将 46 名正常空肠长度小于 200 厘米且无功能结肠的患者与 38 名空肠长度相似且具有功能结肠连续性的患者进行了比较。女性占多数（67%），每组中最常见的诊断是克罗恩病（46 例中的 33 例无结肠，38 例中的 16 例有结肠）。所有无结肠且空肠小于85cm的患者以及所有有结肠且空肠小于45cm的患者都需要长期肠外营养。最后一次切除后六个月，17 名空肠小于 100 厘米且无结肠的患者中有 12 名需要静脉补充，而 21 名有结肠的患者中有 7 名需要静脉补充。在 6 个月到 2 年间，尽管体重有所增加，但两组的营养/液体需求几乎没有变化。在 71 名中位 5 年的临床评估患者中，没有一名空肠和结肠长度超过 50 厘米的患者需要肠外补充剂。大多数（27 人中的 25 人）没有结肠且不需要肠外补充剂的人需要口服电解质补充，而有结肠的人（27 人中的 4 人）则很少。没有结肠的患者中没有一人出现症状性肾结石，而 38 名有结肠的患者中有 9 名 (24%) 出现症状性肾结石 (p
Forty six patients with less than 200 cm of normal jejunum and no functioning colon were compared with 38 patients with similar jejunal lengths in continuity with a functioning colon. Women predominated (67%), and the most common diagnosis in each group was Crohn's disease (33 of 46 no colon, 16 of 38 with colon). All patients without a colon and less than 85 cm of jejunum and all those with a colon and less than 45 cm jejunum needed long term parenteral nutrition. Six months after the last resection 12 of 17 patients with less than 100 cm jejunum and no colon needed intravenous supplements compared with 7 of 21 with a colon. Between 6 months and 2 years, little change occurred in the nutritional/fluid requirements in either group, though there was weight gain. Of 71 patients assessed clinically at a median of 5 years, none with more than 50 cm of jejunum and a colon needed parenteral supplements. Most (25 of 27) of those without a colon who did not need parenteral supplements required oral electrolyte replacement compared with few (4 of 27) with a colon. None of the patients without a colon developed symptomatic renal stones compared with 9 of 38 (24%) with a colon (p