成人肝移植围手术期营养支持的研究进展  

Advances in nutrition support during perioperative period of adult liver transplantation

作　　者：蒋志雄 丁香莹 Jiang Zhixiong;Ding Xiangying(Department of Clinical Nutrition,The Second Affiliated Hospital of Guangxi Medical University,Nanning 530007,China)

机构地区：[1]广西医科大学第二附属医院临床营养科,南宁530007

出　　处：《中华消化外科杂志》2023年第12期1426-1432,共7页Chinese Journal of Digestive Surgery

摘　　要：肝移植围手术期患者因肝脏代谢功能障碍,导致机体糖、蛋白质、脂肪等代谢紊乱进而引起的营养不良成为终末期肝病患者最常见并发症。营养支持是肝移植全过程中的重要内容,围手术期营养支持可改善患者术前营养状况,增加肝移植机会,降低术后病死率及改善预后。笔者回顾近期肝移植围手术期营养支持的干预措施,分析营养筛查和营养评估工具及其优缺点,强调早期营养状况的正确评估,给予合理、个性化肠内肠外营养支持方案,尤其对能量、蛋白质等营养素的需求,以及术后长期合理的营养支持、监测和饮食营养健康教育等的重要性,以期为改善肝移植患者的营养状况提供参考和建议,为构建标准化的肝移植围手术期营养支持方案提供循证依据。The most common complication in patients with end‑stage liver disease is mal‑nutrition,which is caused by the metabolic disorders of sugar,protein and fat for the metabolic dysfunction of liver during the perioperative period of liver transplantation.Nutritional support is very important during the liver transplantation.Perioperative nutritional support can improve the nutritional status of patients,increase the chance of liver transplantation,reduce postoperative mortality and improve outcome.By reviewing the recent interventions of perioperative nutrition support for liver transplantation,and analyzing nutritional screening and nutritional assessment tools and their advantages and disadvantages,the authors emphasize the rational assessment of early nutrition,provide reasonable and personalized parenteral and enteral nutrition support,especially for energy,protein and other nutrients.We also emphasize the importance of long‑term reasonable nutrition support,monitoring and diet nutrition education in order to provide reference and suggestion for improving the nutritional status of liver transplantation patients and to provide evidence‑based basis for constructing standardized perioperative nutrition support program of liver transplantation.

关 键 词：肝移植 营养不良 营养筛查 营养评估 营养支持 

分 类 号：R657.3[医药卫生—外科学]