PDF(Pubmed)
Abstract：
OBJECTIVE: The intestinal rehabilitation program (IRP) is a specialized approach to managing patients with intestinal failure (IF). The goal of IRP is to reduce the patient\'s dependence on parenteral nutrition by optimizing nutrition intake while minimizing the risk of complications and providing individualized medical and surgical treatment. We aimed to provide a thorough overview of our extensive history in adult IRP.
METHODS: We reviewed the medical records of adults with IF treated at our center\'s IRP over the past two decades. We collected data on demographic and clinical results, such as the causes of IF, the current status of the remaining bowel, nutritional support, and complications or mortality related to IF or prolonged parenteral nutrition.
RESULTS: We analyzed a total of 47 adult patients with a median follow-up of 6.7 years. The most common cause of IF was massive bowel resection due to mesenteric vessel thrombosis (38.3%). Twenty-eight patients underwent rehabilitative surgery, including 12 intestinal transplants. The 5-year survival rate was 81.9% with 13 patients who expired due to sepsis, liver failure, or complication after transplantation. Of the remaining 34 patients, 18 were successfully weaned off from parenteral nutrition.
CONCLUSIONS: Our results of IRP over two decades suggest that the individualized and multidisciplinary program for adult IF is a promising approach for improving patient outcomes and achieving nutritional autonomy.
METHODS: We reviewed the medical records of adults with IF treated at our center\'s IRP over the past two decades. We collected data on demographic and clinical results, such as the causes of IF, the current status of the remaining bowel, nutritional support, and complications or mortality related to IF or prolonged parenteral nutrition.
RESULTS: We analyzed a total of 47 adult patients with a median follow-up of 6.7 years. The most common cause of IF was massive bowel resection due to mesenteric vessel thrombosis (38.3%). Twenty-eight patients underwent rehabilitative surgery, including 12 intestinal transplants. The 5-year survival rate was 81.9% with 13 patients who expired due to sepsis, liver failure, or complication after transplantation. Of the remaining 34 patients, 18 were successfully weaned off from parenteral nutrition.
CONCLUSIONS: Our results of IRP over two decades suggest that the individualized and multidisciplinary program for adult IF is a promising approach for improving patient outcomes and achieving nutritional autonomy.
摘要：
目的：肠道康复计划（IRP）是管理肠衰竭（IF）患者的专门方法。IRP的目标是通过优化营养摄入，同时将并发症的风险降至最低，并提供个体化的医疗和手术治疗，从而减少患者对肠外营养的依赖。我们旨在全面概述我们在成人IRP中的广泛历史。
方法：我们回顾了过去20年在我们中心IRP治疗的IF成人的医疗记录。我们收集了人口统计学和临床结果的数据，例如IF的原因，剩余肠道的现状，营养支持,以及与IF或延长肠外营养相关的并发症或死亡率。
结果：我们分析了47例成人患者，中位随访时间为6.7年。IF的最常见原因是肠系膜血管血栓形成引起的大量肠切除（38.3％）。二十八位病人接受了康复手术,包括12例肠道移植.13例因败血症而过期的患者的5年生存率为81.9%，肝功能衰竭,或移植后的并发症。在剩下的34名患者中，18例成功脱离肠外营养。
结论：我们20年IRP的研究结果表明，针对成人IF的个性化和多学科计划是改善患者预后和实现营养自主性的有希望的方法。
方法：我们回顾了过去20年在我们中心IRP治疗的IF成人的医疗记录。我们收集了人口统计学和临床结果的数据，例如IF的原因，剩余肠道的现状，营养支持,以及与IF或延长肠外营养相关的并发症或死亡率。
结果：我们分析了47例成人患者，中位随访时间为6.7年。IF的最常见原因是肠系膜血管血栓形成引起的大量肠切除（38.3％）。二十八位病人接受了康复手术,包括12例肠道移植.13例因败血症而过期的患者的5年生存率为81.9%，肝功能衰竭,或移植后的并发症。在剩下的34名患者中，18例成功脱离肠外营养。
结论：我们20年IRP的研究结果表明，针对成人IF的个性化和多学科计划是改善患者预后和实现营养自主性的有希望的方法。
