围术期营养支持治疗的研究进展
Research progress of nutritional support therapy in the perioperative period
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摘要:
规范化临床营养支持治疗可以改善患者的营养状况,提高患者的手术耐受力,减少术后并发症的发生。围术期营养支持治疗方案首选肠内营养支持治疗,需要营养支持治疗的患者在肠内营养支持治疗无法达到目标剂量>3 d时,推荐施行补充性肠外营养。加速康复外科(ERAS)主要是优化围术期处理措施。随着研究者对ERAS的不断深入探索,相应的围术期营养支持治疗也得到了更新和拓展。手术患者营养风险评估、术前营养不良的纠正等已成为ERAS的重要组成部分。围术期营养支持治疗的含义不再仅仅是能量供给,也包括调控手术患者的病理生理改变。这是促进外科康复的必需措施,也是强化围术期处理的重要环节。
Abstract:Standardized nutritional support therapy can improve the nutrition status and surgical tolerance as well as reducing postoperative complications. The enteral nutritional support therapy is recommended as the first choice, while supplementary parenteral nutrition will be applied to the patients when enteral nutritional support therapy cannot achieve target supplement for more than 3 days. Enhanced recovery after surgery (ERAS) focuses on the optimization of preoperative managements, which also greatly update the strategy of nutritional support therapy. Risk assessment of nutrition in patients with surgery and correction of preoperative malnutrition are becoming important parts of ERAS. Preoperative nutritional support therapy not only emphasizes the energy supplement, but also regulates pathophysiologic changes of patients with surgery. It has been regarded as a mandatory method to enhance postoperative recovery and optimize preoperative managements.
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