sibmedСибирский научный медицинский журналСибирский научный медицинский журнал2410-25122410-2520ИЦиГ СО РАН10.18699/SSMJ20250324sibmed-2260Research ArticleКЛИНИЧЕСКИЙ СЛУЧАЙCASE REPORTПарентеральное питание через венозную порт-систему у пациентов с синдромом короткой кишки (обзор литературы и описание клинического случая)Parenteral nutrition through the venous port system in patients with short bowel syndrome (literature review and clinical case)https://orcid.org/0000-0002-1289-3278РепинА. А.RepinA. A.

Андрей Александрович Репин

443079; пр. Карла Маркса, 165б; Самара

Andrey A. Repin

443079; Karla Marxa ave., 165b; Samara

a168i@yandex.ruhttps://orcid.org/0000-0002-6759-6115МельниковМ. А.MelnikovM. A.

Михаил Александрович Мельников, к. м. н.

443079; пр. Карла Маркса, 165б; Самара

Mikhail A. Melnikov, candidate of medical sciences

443079; Karla Marxa ave., 165b; Samara

mishafleb@mail.ruhttps://orcid.org/0000-0001-7473-6692КаторкинС. Е.KatorkinS. E.

Сергей Евгеньевич Каторкин, д. м. н., проф.

443099; ул. Чапаевская, 89; Самара

Sergey E. Katorkin, doctor of medical sciences, professor

443099; Chapaevskaya st., 89; Samara

katorkinse@mail.ruhttps://orcid.org/0000-0001-5123-7057БондаренкоС. Ю.BondarenkoS. Yu.

Сергей Юрьевич Бондаренко

443079; пр. Карла Маркса, 165б; Самара

Sergey Yu. Bondarenko

443079; Karla Marxa ave., 165b; Samara

samara.bondarenko@yandex.ruКлиники Самарского государственного медицинского университета Минздрава РоссииРоссияСlinics of the Samara State Medical University of Minzdrav of RussiaRussian FederationСамарский государственный медицинский университет Минздрава РоссииРоссияSamara State Medical University of Minzdrav of RussiaRussian Federation202513072025453198207Copyright © Репин А.А., Мельников М.А., Каторкин С.Е., Бондаренко С.Ю., 20252025Репин А.А., Мельников М.А., Каторкин С.Е., Бондаренко С.Ю.Repin A.A., Melnikov M.A., Katorkin S.E., Bondarenko S.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://sibmed.elpub.ru/jour/article/view/2260   Введение

   Введение.  Синдром короткой кишки – редкое заболевание, возникающее после удаления большой части тонкой кишки или из-за аномалий развития в эмбриональном периоде. Такие пациенты нуждаются в длительном лечении, жизненно необходимой составляющей которого является парентеральное питание (ПП). Для осуществления ПП требуется постоянный сосудистый доступ, проблема выбора которого всегда является актуальной темой из-за рисков различных осложнений. Венозная порт-система – оптимальный вид сосудистого доступа для ПП в связи с низким уровнем интраоперационных и послеоперационных осложнений и простотой эксплуатации.

   Цель исследования ‒ представить клинический случай имплантации венозной порт-системы и ее использование в качестве сосудистого доступа для ПП пациента с синдромом короткой кишки.

   Клинический случай

   Клинический случай. Пациент Г., 30 лет, с диагнозом: «Состояние после аппендэктомии от 24. 03. 2023, лапаротомии, адгезиолизиса от 30. 04. 2023. Состояние после 9 санационных релапаротомий по поводу третичного перитонита. Синдром короткой кишки (дистальный): резекция дистального участка подвздошной кишки по поводу перфораций тонкой кишки с формированием высокой еюностомы на расстоянии 90 см от связки Трейтца (резидуальный отросток 90 см). Кишечная недостаточность III типа, синдром нарушения всасывания 2-й степени, тяжелое течение. Белково-энергетическая недостаточность тяжелой степени. Гипоальбуминемия, гипопротеинемия». В Клиниках Самарского государственного медицинского университета выполнена имплантация венозной порт-системы в верхнюю полую вену через правую внутреннюю яремную вену с расположением камеры в правой подключичной области. Выписан на амбулаторное долечивание в стабильном состоянии с положительной динамикой.

   Заключение

   Заключение. Использование венозной порт-системы в качестве доступа для ПП у тяжелых и астеничных пациентов с синдромом короткой кишки позволяет минимизировать осложнения, эффективно и удобно для обеспечения ПП.

   Introduction

   Introduction. Short bowel syndrome is a rare disease that occurs after the removal of a large part of the small intestine or due to developmental abnormalities in the embryonic period. Such patients need long-term treatment, the vital component of which is parenteral nutrition (PN). PN requires constant vascular access, the problem of choosing which is always an urgent topic due to the risks of various complications. The venous port system is the optimal type of vascular access for PN due to the low level of intraoperative and postoperative complications and ease of operation.

   The aim of the study is to present a clinical case of venous port system implantation and its use as a vascular access for PN of a patient with short bowel syndrome.

   Clinical case

   Clinical case. Patient G., 30 years old, with a diagnosis: “Condition after appendectomy on 24.03.2023, laparotomy, adhesiolysis on 30.04.2023. Condition after 9 sanitation relaparotomies fortertiary peritonitis. Short bowel syndrome (distal): resection of the distal ileum for small intestinal perforations with the formation of a high jejunostomy at a distance of 90 cm from the ligament of Treitz (residual process 90 cm). Intestinal failure type III, malabsorption syndrome stage 2, severe course. Severe protein-energy malnutrition. Hypoalbuminemia, hypoproteinemia”. Surgery was performed in the Clinics of Samara State Medical University: Implantation of the venous port system into the superior vena cava through the right internal jugular vein with the chamber located in the rightsubclavian region. He was discharged for outpatient follow-up treatment in a stable condition with positive dynamics.

   Conclusions

   Conclusions. The use of the venous port system as an access for PN in severe and asthenic patients with short bowel syndrome minimizes complications, effectively and conveniently provides PN.

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The authors declare that there are no conflicts of interest present.