PDF(Pubmed)
Abstract：
Malnutrition poses a critical challenge in inflammatory bowel disease, with the potential to detrimentally impact medical treatment, surgical outcomes, and general well-being. Parenteral nutrition is crucial in certain clinical scenarios, such as with patients suffering from short bowel syndrome, intestinal insufficiency, high-yielding gastrointestinal fistula, or complete small bowel obstruction, to effectively manage malnutrition. Nevertheless, research over the years has attempted to define the potential effects of parenteral nutrition on the intestinal barrier and the composition of the gut microbiota. In this narrative review, we have gathered and analyzed findings from both preclinical and clinical studies on this topic. Based on existing evidence, there is a clear correlation between short- and long-term parenteral nutrition and negative effects on the intestinal system. These include mucosal atrophic damage and immunological and neuroendocrine dysregulation, as well as alterations in gut barrier permeability and microbiota composition. However, the mechanistic role of these changes in inflammatory bowel disease remains unclear. Therefore, further research is necessary to effectively address the numerous gaps and unanswered questions pertaining to these issues.
摘要：
营养不良对炎症性肠病构成了严峻的挑战，有可能对医疗产生不利影响，手术结果,和总体福祉。肠外营养在某些临床情况下至关重要，例如患有短肠综合征的患者，肠道功能不全,高产胃肠瘘，或者完全小肠梗阻，有效管理营养不良。然而，多年来的研究试图确定肠外营养对肠屏障和肠道微生物群组成的潜在影响。在这篇叙述性评论中，我们收集并分析了该主题的临床前和临床研究的结果.根据现有证据,短期和长期肠外营养与对肠道系统的负面影响之间存在明显的相关性。这些包括粘膜萎缩性损伤和免疫和神经内分泌失调，以及肠道屏障通透性和微生物群组成的变化。然而,这些变化在炎症性肠病中的作用机制尚不清楚.因此,需要进一步研究，以有效解决与这些问题有关的众多差距和悬而未决的问题。
