小肠全切除后全肠外营养支持存活一例报告

Long term TPN support and survival after total mesenteric small intestine resection and right hemicoloctomy——A case report

报告一例因外伤行肠切除吻合术后因肠粘连、肠扭转、肠坏死、肠系膜栓塞而多次行小肠切除而行十二指肠-结肠吻合术患者,术后发生严重的短肠综合症(SBS),经抢救和TPN长期治疗现存活3年,可行轻体力劳动和正常饮食。

One case, 38 years, had under gone enteroctomy 20 years ago for trauma. He was taken to the mergency room of our hospital for a midgut volvulus with diffuse bowel gangrene, general peritoitis, and septic shock. A massive resection of small in testine with the exception of proximal 30 cm jejunum, right hemicoloctomy, and a jejunocolostomy were perfomed. One Month after the first operation, he again suffered from acute abdominal pain and intestinal obstruction. The mensentic blood vessels of the remaining jejunum were occluded and the mucosa was necrotic. A jejunectomy and a duodenocolostomy were perfomed. He suffrerd from srvere SBS after operation and he received TPN supporting. Five months after the second operation, he was discharged and supported by home parenteral nutrition(HPN). He dispensed the TPN solution (all in one )by himself at home and infused it intravenousely at night lasting 8-12 hours and lock the catheter by a PRN adapter in the morning. One year after the second operation, he went to work 4 hours a day, and a half year later, he could work normally. Till now he had survived for three years and can eat some normal food three times a day with his family. He has good nutriture, health, and good quality of life.