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短肠综合征儿童中小肠细菌过度生长:危险因素,临床表现和管理 - - 一个单一中心的经验
Maja Velimirovic1, Veronika Osterman1,2, Ana Prislan1
1Department of Pediatric Surgery, Division of Surgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.
Children (Basel, Switzerland)
|March 28, 2025
概括
小肠细菌过度生长 (SIBO) 在短肠综合征 (SBS) 的儿童中很常见,影响了他们从家庭亲肠营养 (HPN) 过渡的能力. 早期怀疑和个性化抗生素治疗是管理这种脆弱人群中SIBO的关键.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 肠道康复 肠道康复
- 微生物组研究 微生物组研究
背景情况:
- 儿童的短肠综合征 (SBS) 呈现肠道功能障碍,增加了小肠细菌过度生长 (SIBO) 的风险.
- 在SBS管理中经常需要家庭亲肠营养 (HPN),但SIBO可能会使HPN的断奶复杂化.
- 了解SIBO对SBS患者的影响对于优化治疗结果至关重要.
研究的目的:
- 描述儿童SBS患者在HPN上的SIBO的经验.
- 在这个队列中确定SIBO的风险因素,临床表现和有效的抗生素治疗方法.
- 评估SIBO对HPN断奶能力的影响.
主要方法:
- 一个单一中心的回顾性描述性队列研究.
- 在2018年1月至2022年12月期间,包括16名患有SBS的儿童在HPN上.
- 对临床怀疑的SIBO发作进行分析,重点关注风险因素,症状和抗生素干预措施.
主要成果:
- 五名儿童 (31.2%) 经历了SIBO发作,常见症状包括腹 (76%) 和流星 (56%).
- 抗生素治疗有所不同,其中56%的发作是用一种抗生素治疗的.
- 经过一轮抗生素治疗,56%的患者出现症状缓解;两名儿童患有耐火性SIBO,需要循环治疗.
结论:
- 对于将SBS儿童从HPN中断奶,SIBO构成了一个重大挑战.
- 由于诊断测试的局限性,早期临床怀疑至关重要.
- 需要个性化的抗生素策略,考虑到患者特异性因素和复发风险.
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