摘要目的探讨短肠康复治疗对改善短肠病人营养状况、促进肠功能代偿的疗效.方法短肠康复治疗包括营养支持、应用谷氨酰胺和生长激素,以及膳食纤维.共27例短肠患者接受了29次康复治疗,患者平均年龄38.5±19.3岁.剩余小肠长度范围15-80 cm,平均46. 8±23.4 cm,14例有回盲瓣.从肠切除至接受康复治疗的平均时间为86±105天.结果治疗后病人的营养状况明显改善,肠道吸收功能有所增强.随访超过2年者8例,4例(50%) 完全脱离肠外营养,随访时间超过1年者13例,有10例(76.9%)完全脱离肠外营养.结论短肠康复治疗能够有效地改善短肠病人的营养状况、并能促进肠功能代偿,治疗效果与残留小肠长度、治疗开始的时间和病人年龄有关,及早进行康复治疗能够促进肠功能代偿,减少病人对肠外营养的依赖.

abstractsObjective To investigate the effect of rehabilitation therapy for short bowel syndrome on patient nutritional status and intestinal adaptation.Methods The rehabilitation therapy included enteral or parenteral nutrition, glutamine, recombinant human growth hormone and rehabilitative diet. From January 1997 to July 2000, twenty-seven patients with short bowel syndrome received the treatme nt. The average age of the patients was 38.5±19.3 years, and the length of r esidual small intestine ranged from 15 to 80 cm, with an average of 46.8±23.4 cm. The ileocecal valve was preserved in 14 cases, and the average time betwee n the onset of short bowel syndrome and the rehabilitation therapy was 86±105 d ays.Results After the treatment, nutritional status of the patients improved markedly, and i ntestinal absorptive capacity improved. Eight patients were followed up for mor e than 2 years, among whom 4 (50%) were weaned from total parenteral nutrition. Thirteen patients were followed up for more than 1 year, and 10 patients (76.9 %) were weaned from total parenteral nutrition.Conclusions Rehabilitation therapy for short bowel syndrome can improve patient nutritional status effectively and promote intestinal adaptation, providing a new hope for t hese patients. The therapeutic effects are related to the length of the residua l small intestine, patient's age and duration between massive intestinal resecti on and start of the treatment. Early initiation of rehabilitation therapy promo tes intestinal adaptation and increases patient's ability to wean from total par enteral nutrition.