术后肠外营养在择期手术中的作用术后肠外营养患者及条件的选择

Jong Won Kim
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摘要

术后早期肠内营养或早期口服摄入建议手术患者。在这种情况下,本研究探讨了肠外营养在择期手术患者术后的作用。术前应评估营养状况,如出现营养不良,术前应给予营养支持,以获得良好效果。术后超过2周的营养支持不足可能使患者病情恶化。因此,如果术后7天或术后5 ~ 7天口服摄入不适宜,建议开始营养护理。肠内营养与肠功能的快速恢复和减少感染相关并发症有关。因此,肠内营养具有优先权。另一方面,根据患者的情况,可能无法进行肠内营养,并且早期肠内营养的统一实施可能会给患者带来负担。肠外营养的优点是可以在不受肠道状况影响的情况下提供营养,并且可以根据需要计算提供尽可能多的能量。择期手术后需要肠外营养的情况可归纳为:1)术前接受营养治疗,术后不能耐受口服或肠内营养的患者。或2)术后7天肠内营养未满足50%需求,判断此种情况应持续7天。(中华外科杂志2018;9:1-4)
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Role of Postoperative Parenteral Nutrition in Elective Surgery; Selection of Patients and Conditions for Postoperative Parenteral Nutrition
Postoperative early enteral nutrition or early oral ingestion is recommended in surgical patients. In this situation, this study examined the role of parenteral nutrition in the postoperative period in patients undergoing elective surgery. The nutritional status should be assessed before surgery and in the case of malnutrition, nutritional support should be provided before surgery to obtain good results. More than 2 weeks of insufficient nutritional support after surgery may worsen the patient's progress. Therefore, it is recommended to start nutritional care if the oral intake is not appropriate until 7 days or 5 to 7 days after surgery. Enteral nutrition is related to the quick restoration of the bowel function and reduction of infection-related complications. Therefore, enteral nutrition has priority. On the other hand, depending on the patient's condition, it may not be possible to perform enteral nutrition, and the uniform implementation of the early enteral nutrition may be a burden to the patient. Parenteral nutrition has the advantage that it can supply nutrition without being affected by the intestinal condition, and it can be calculated to supply as much energy as required. The situation, where parenteral nutrition is required after elective surgery, could be summarized as 1) the patients who underwent nutritional therapy before surgery and could not tolerate oral intake or enteral nutrition after surgery. or 2) in the case where enteral nutrition did not satisfy 50% of the demand at 7 days after surgery, and it is judged that this situation should continue for 7 days. (Surg Metab Nutr 2018;9:1-4)
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