谷氨酰胺和生长激素与短肠患者肠功能恢复(附1例报道)(英文)

The role of glutamine and recombinant growth hormone as adjuvant management of the patient with extensive small bowel and total colon resection: a case report

小肠次全切除通常导致患者营养吸收障碍。在没有肠外营养的条件下,此类患者的长期生存依赖于肠道功能的恢复,即残留小肠的吸收功能的增强。一名56岁男性患者因肠系膜反复自发出血,先后行3次手术治疗,最终导致小肠次全切除并全结肠切除。第3次手术后,在肠外营养的基础上,给予生长激素和L-谷氨酰胺治疗。治疗1个月,患者完全脱离肠外营养。术后1年,患者体重增加7kg。实验室检测血红蛋白浓度112g/L,白蛋白36.8g/L。此病例提示我们在全结肠切除的情况下,120cm残留回肠可以满足患者的营养需求。生长激素和L-谷氨酰胺的应用可以促进残留回肠吸收功能的恢复。

The extensive resection of the intestine often causes the malabsorptive state.Long-term survival without parenteral nutrition（PN） depends on the process of intestinal adaptation,through which the remaining small bowel gradually increases its absorptive capacity.A 56-years-old man with bowel obstruction by spontaneous colonic mesenteric hemorrhage repeatedly was performed extensive small-bowel resection and total colectomy thorough 3 times of operation.After the 3rd operation,PN was given assisted with GH and L-glutamine postoperatively.One month after therapy,the patient completely remained off PN.One year after the 3rd operation,the body weight had increased 7kg.Laboratory examination revealed hemoglobin 112 g/L,albumin 36.8 g/L.This case indicated that the 120 cm ileum was sufficient to the adult patient with total colectomy.The GH and L-glutamine may accelerate the adaptation procedure of the remnant ileum.