营养干预对重症酒精性肝病患者预后的影响  

Effects of nutritional intervention on prognosis of patients with severe alcoholic liver disease

作　　者：刘婉姝[1] 翟庆慧[1] 宋芳娇 朱冰[1] 辛绍杰[1] 臧红[2] 游绍莉[1] LIU Wan-shu;ZHAI Qing-hui;SONG Fang-jiao;ZHU Bing;XIN Shao-jie;ZANG Hong;YOU Shao-li(Liver Failure Treatment and Research Center,302 Hospital of PLA,Beijing 100039,China;Liver Transplantation Center,302 Hospital of PLA,Beijing 100039,China)

机构地区：[1]解放军第三〇二医院肝衰竭诊疗与研究中心,北京100039 [2]解放军第三〇二医院肝移植研究中心,北京100039

出　　处：《中国肝脏病杂志（电子版）》2018年第3期61-65,共5页Chinese Journal of Liver Diseases：Electronic Version

基　　金：国家"十二五"科技重大专项(2012ZX10002004-005);国家"十三五"科技重大专项(2017ZX10002008-003);解放军第三〇二医院青年培育项目(QNPY2015001);首都市民健康项目培育(Z151100003915156)

摘　　要：目的探讨营养干预对重症酒精性肝病(severe alcoholic liver disease,SALD)患者营养状态、肝功能改善、相关并发症发生及病死率的影响。方法将2016年1月至2017年6月解放军第三〇二医院收治的60例SALD患者随机分为干预组和对照组,每组30例。对照组患者进行常规内科治疗、戒酒及自主饮食;营养干预组患者在对照组患者治疗基础上进行相关营养干预,干预时间为12周,比较两组患者的营养状态、肝功能恢复、并发症发生率及180天病死率差异。结果干预组患者经营养干预后,营养状态及肝功能指标(MELD评分、血清总胆红素、白蛋白和前白蛋白等)较对照组有显著改善(P <0.05),并发症发生率(肝性脑病、食管胃底静脉曲张破裂出血、肝肾综合征、腹水)及病死率均显著低于对照组(P <0.05)。结论营养干预可改善SALD患者的营养状态,促进肝功能恢复,降低相关并发症及病死率的发生。Objective To investigate the effects of nutritional intervention on nutritional status, liver function improvement, related complications and mortality in patients with severe alcoholic liver disease （SALD）. Methods Total of 60 cases with SALD in 302 Hospital of PLA from January 2016 to June 2017 were randomly divided into intervention group and control group, 30 cases in each group. Patients in control group were treated with routine medical treatment, abstinence and independent diet, and patients in intervention group were treated with related nutrition intervention on the basis of routine medical treatment. The intervention period was 12 weeks. The nutritional status, recovery of liver function, occurrence of complications and mortality rate were compared between the two groups. Results The nutritional status and liver function indexes （MELD score, serum total bilirubin, albumin, prealbumin, etc.） of patients in intervention group improved significantly compared with those in control group （P 〈 0.05）. The occurrence of complications （hepatic encephalopathy, esophageal and gastric fundus variceal bleeding, hepatorenal syndrome and ascites） and mortality rate were lower than those of control group （P 〈 0.05）. Conclusions Nutritional intervention can improve the nutritional status, promote the recovery of liver function, reduce the occurrence of related complications and the mortality rate of patients with SALD.

关 键 词：肝病 重症 酒精性 营养干预 肠内营养 

分 类 号：R575[医药卫生—消化系统]