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Clin Nutr：家庭肠外营养治疗减肥手术后并发症，效果如何？

2016-09-12 Mechront 译 MedSci原创

家庭肠外营养减肥手术肥胖
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有一点无需置疑：肥胖是一个世界性的健康问题。还有一点也无需置疑：减肥手术（BS）是对抗肥胖及其相关合并症的最常用治疗方式之一。 不过，目前的减肥手术会导致一些早期或晚期并发症，患者可能需要营养支持。本回顾性研究的研究对象为因减肥手术后并发症进行家庭肠外营养(HPN)的患者，旨在评估HPN对患者的影响。 通过对HPN中心患者使用ESPEN HAN/CIF工作组设计的特定问卷进行调查，收集

有一点无需置疑：肥胖是一个世界性的健康问题。还有一点也无需置疑：减肥手术（BS）是对抗肥胖及其相关合并症的最常用治疗方式之一。

不过，目前的减肥手术会导致一些早期或晚期并发症，患者可能需要营养支持。本回顾性研究的研究对象为因减肥手术后并发症进行家庭肠外营养(HPN)的患者，旨在评估HPN对患者的影响。

通过对HPN中心患者使用ESPEN HAN/CIF工作组设计的特定问卷进行调查，收集相关数据。问卷内容包括：患者的人口统计资料、手术类型、术前BMI、开始HPN时的BMI、包括技术和营养并发症（术后2个月内或以后）相关的HPN指征、患者结局、PN方案和HPN相关并发症。本项回顾性分析纳入了2008年1月6日至2014年6月的患者。

共有18岁HPN中心参与了此项调查，涉及2880例HPN患者，77例进行了BS（女性有65例，平均年龄51±7年），胃旁路术占69%，术前平均BMI为44.4，开始HPN时的BMI为23.2。HPN适应症：17例是早期并发症，60例为晚期并发症。基本上所有的早期并发症都是吻合口瘘，晚期并发症则有低蛋白血症、维生素和微量元素缺乏。77例患者中，16需要再次手术干预，29例停止HPN，6例死亡（与HPN无关）。HPN期间，58%的患者再住院，41%的患者出现中央静脉并发症。17例患者伴有糖尿病。HPN支持了60例患者，但也排异了17例患者（平均热量摄入：23±6 kcal/k BW/天+1.2 g/kBW/天），只有7例患者在HPN期间恢复了专业活动。

这是迄今为止最大的，关于减肥手术后并发症患者进行HPN治疗的多中心观察性研究。数据显示，严重的低白蛋白血症是主要的晚期并发症；患者的再住院和CVC感染率高。HPN可以作为减肥术后和手术恢复前的“桥梁”；但是高死亡率也反映了这些情况的复杂性。

原始出处：

A. Van Gossum,et al.Home Parenteral Nutrition (HPN) in patients with post-bariatric surgery complications.Clin Nutr.Published online: September 8, 2016

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    2017-07-05 ms6519009802973839

    #家庭肠外营养#

    0

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    2016-12-13 丁鹏鹏

    #并发#

    0

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objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Sep 14 09:53:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=126291, encodeId=4dc312629184, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Sep 14 09:53:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305847, encodeId=f90a130584ea2, content=<a href='/topic/show?id=92138155222' target=_blank style='color:#2F92EE;'>#肠外营养#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81552, encryptionId=92138155222, topicName=肠外营养)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8e0333, createdName=zhangyxzsh, createdTime=Wed Sep 14 01:38:00 CST 2016, time=2016-09-14, status=1, ipAttribution=)]
    2016-09-22 1e10c84am36(暂无匿称)

    文章很好，非常有益

    0

  4. 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objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Sep 14 09:53:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=126291, encodeId=4dc312629184, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Sep 14 09:53:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305847, encodeId=f90a130584ea2, content=<a href='/topic/show?id=92138155222' target=_blank style='color:#2F92EE;'>#肠外营养#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81552, encryptionId=92138155222, topicName=肠外营养)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8e0333, createdName=zhangyxzsh, createdTime=Wed Sep 14 01:38:00 CST 2016, time=2016-09-14, status=1, ipAttribution=)]
    2016-09-17 doctorJiangchao

    继续学习

    0

  5. 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GetPortalCommentsPageByObjectIdResponse(id=1305847, encodeId=f90a130584ea2, content=<a href='/topic/show?id=92138155222' target=_blank style='color:#2F92EE;'>#肠外营养#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81552, encryptionId=92138155222, topicName=肠外营养)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8e0333, createdName=zhangyxzsh, createdTime=Wed Sep 14 01:38:00 CST 2016, time=2016-09-14, status=1, ipAttribution=)]
    2016-09-17 doctorJiangchao

    继续关注

    0

  6. 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objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Sep 14 09:53:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=126291, encodeId=4dc312629184, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Sep 14 09:53:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305847, encodeId=f90a130584ea2, content=<a href='/topic/show?id=92138155222' target=_blank style='color:#2F92EE;'>#肠外营养#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81552, encryptionId=92138155222, topicName=肠外营养)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8e0333, createdName=zhangyxzsh, createdTime=Wed Sep 14 01:38:00 CST 2016, time=2016-09-14, status=1, ipAttribution=)]
    2016-09-16 lhl629

    学习学习。。

    0

  7. 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    2016-09-14 1dd8a7c5m95(暂无匿称)

    学习了，赞一个！！！

    0

  8. 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objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Sep 14 09:53:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=126291, encodeId=4dc312629184, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Sep 14 09:53:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), 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    2016-09-14 doctorJiangchao

    继续学习

    0

  9. 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content=学习学习。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ceb079804, createdName=lhl629, createdTime=Fri Sep 16 06:05:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=126417, encodeId=47d912641e34, content=学习了，赞一个！！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Wed Sep 14 11:00:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=126290, encodeId=21a0126290b8, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Sep 14 09:53:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=126291, encodeId=4dc312629184, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Sep 14 09:53:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305847, encodeId=f90a130584ea2, content=<a href='/topic/show?id=92138155222' target=_blank style='color:#2F92EE;'>#肠外营养#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81552, encryptionId=92138155222, topicName=肠外营养)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8e0333, createdName=zhangyxzsh, createdTime=Wed Sep 14 01:38:00 CST 2016, time=2016-09-14, status=1, ipAttribution=)]
    2016-09-14 doctorJiangchao

    继续关注

    0

  10. 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topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Tue Dec 13 22:38:00 CST 2016, time=2016-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=132855, encodeId=9c9d13285531, content=文章很好，非常有益, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Thu Sep 22 09:10:00 CST 2016, time=2016-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129576, encodeId=0de61295e6a8, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sat Sep 17 14:15:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129577, encodeId=e88c1295e798, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sat Sep 17 14:15:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128301, encodeId=4a0912830191, content=学习学习。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ceb079804, createdName=lhl629, createdTime=Fri Sep 16 06:05:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=126417, encodeId=47d912641e34, content=学习了，赞一个！！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Wed Sep 14 11:00:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=126290, encodeId=21a0126290b8, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Sep 14 09:53:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=126291, encodeId=4dc312629184, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Sep 14 09:53:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305847, encodeId=f90a130584ea2, content=<a href='/topic/show?id=92138155222' target=_blank style='color:#2F92EE;'>#肠外营养#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81552, encryptionId=92138155222, topicName=肠外营养)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8e0333, createdName=zhangyxzsh, createdTime=Wed Sep 14 01:38:00 CST 2016, time=2016-09-14, status=1, ipAttribution=)]
    2016-09-14 zhangyxzsh

    #肠外营养#

    0

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