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终末期肝病的营养不良评价体系和营养支持治疗

朱彬 邹聪聪 郑昕

引用本文:
Citation:

终末期肝病的营养不良评价体系和营养支持治疗

DOI: 10.3969/j.issn.1001-5256.2017.09.014
详细信息
  • 中图分类号: R575.3

Malnutrition assessment and nutrition support therapy for end-stage liver disease

  • 摘要: 营养不良是终末期肝病的常见并发症,与患者的临床预后和生存质量相关,但尚未引起临床医师的足够重视。简述了终末期肝病营养不良的发生机制,重点介绍了国内外关于终末期肝病的营养不良评价体系和营养支持治疗新进展。对终末期肝病患者尽早采取科学的营养支持治疗将有助于提高临床疗效,改善患者预后。

     

  • [1]JIA JD.Diagnosis and treatment of end-stage liver disease[J].Chin J Hepatol, 2017, 15 (6) :401-402. (in Chinese) 贾继东.终末期肝病的诊疗现状[J].中华肝脏病杂志, 2007, 15 (6) :401-402.
    [2]CEDERHOLM T, BOSAEUS I, BARAZZONI R, et al.Diagnostic criteria for malnutrition-An ESPEN Consensus Statement[J].Clin Nutr, 2015, 34 (3) :335-340.
    [3]ZHAO VM, ZIEGLER TR.Nutrition support in end-stage liver disease[J].Crit Care Nurs Clin North Am, 2010, 22 (3) :369-380.
    [4]JUAKIEM W, TORRES DM, HARRISON SA.Nutrition in cirrhosis and chronic liver disease[J].Clin Liver Dis, 2014, 18 (1) :179-190.
    [5]YAO J, CHANG L, YUAN L.Nutrition status and small intestinal bacterial overgrowth in patients with virus-related cirrhosis[J].A-sia Pac J Clin Nutr, 2016, 25 (2) :283-291.
    [6]ANASTCIO LR.Nutrition therapy:integral part of liver transplant care[J].World J Gastroenterol, 2016, 22 (4) :1513.
    [7]RACHAKONDA V, BORHANI AA, DUNN MA, et al.Serum leptin is a biomarker of malnutrition in decompensated cirrhosis[J].PLo S One, 2016, 11 (9) :e159142.
    [8]BMEUR C, BUTTERWORTH RF.Reprint of:Nutrition in the management of cirrhosis and its neurological complications[J].J Clin Exp Hepatol, 2015, 5 (Suppl 1) :s131-s140.
    [9]DING HG, WANG JT, WANG BS.Dystrophy, abnormal energy metabolism, nutritional support in cirrhotic patients[J].Chin JClin Nutr, 2002, 10 (4) :281-283. (in Chinese) 丁惠国, 汪俊韬, 王宝思.肝硬化患者营养不良、能量代谢异常与营养支持[J].中国临床营养杂志, 2002, 10 (4) :281-283.
    [10]MOUZAKI M, NG V, KAMATH BM, et al.Enteral energy and macronutrients in end-stage liver disease[J].JPEN J Parenter Enteral Nutr, 2014, 38 (6) :673-681.
    [11]MENG QH, LI YX, WANG JH, et al.Nutritional status evaluation in 126 liver cirrhosis patients with hepatitis B virus infection[J].Chin J Clin Nutr, 2008, 16 (4) :233-237. (in Chinese) 孟庆华, 李玉贤, 王金环, 等.126例乙肝肝硬化患者营养状况评价[J].中国临床营养杂志, 2008, 16 (4) :233-237.
    [12]FIGUEIREDO F.Utility of standard nutritional parameters in detecting body cell mass depletion in patients with end-stage liver disease[J].Liver Transpl, 2000, 6 (5) :575-581.
    [13]CAMPILLO B, RICHARDET JP, BORIES PN.Enteral nutrition in severely malnourished and anorectic cirrhotic patients in clinical practice[J].Gastroenterol Clin Biol, 2005, 29 (6-7) :645-651.
    [14]YE Q, XIAO HJ, HAN T, et al.Malnutrition status and body composition in patients with liver cirrhosis[J].Chin J Hepatol, 2016, 24 (5) :380-383. (in Chinese) 叶青, 肖慧娟, 韩涛, 等.肝硬化患者的营养不良状态和体成分分析[J].中华肝脏病杂志, 2016, 24 (5) :380-383.
    [15]FERNANDES SA, BASSANI L, NUNES FF.Nutrition assessment in patients with cirrhosis[J].Arq Gastroenterol, 2012, 49 (1) :19-27.
    [16]BRAGANA AC, ALVARES-da-SILVA MR.Prevalence of diabetes mellitus and impaired glucose tolerance in patients with decompensated cirrhosis being evaluated for liver transplantation:the utility of oral glucose tolerance test[J].Arq Gastroenterol, 2010, 47 (1) :22-27.
    [17] Chinese Medical Association.Guidelines for clinical diagnosis and treatment:parenteral and enteral nutrition[M].Beijing:People's Medical Publishing House, 2008. (in Chinese) 中华医学会.临床诊疗指南:肠外肠内营养学分册[M].北京:人民卫生出版社, 2008.
    [18]WALES PW, ALLEN N, WORTHINGTON P, et al.A.S.P.E.N.clinical guidelines:support of pediatric patients with intestinal failure at risk of parenteral nutrition-associated liver disease[J].JPEN J Parenter Enteral Nutr, 2014, 38 (5) :538-557.
    [19]FIGUEIREDO F, PEREZ R, KONDO M.Effect of liver cirrhosis on body composition:evidence of significant depletion even in mild disease[J].J Gastroenterol Hepatol, 2005, 20 (2) :209-216.
    [20]PIRLICH M, SCHUTZ T, SPACHOS T, et al.Bioelectrical impedance analysis is a useful bedside technique to assess malnutrition in cirrhotic patients with and without ascites[J].Hepatology, 2000, 32 (6) :1208-1215.
    [21]PLAUTH M, CABRE E, RIGGIO O, et al.ESPEN guildlines on enteral nutrition:liver disease[J].Clin Nutr, 2006, 25 (2) :285-294.
    [22]BAKSHI N, SINGH K.Nutrition assessment and its effect on various clinical variables among patients undergoing liver transplant[J].Hepatobiliary Surg Nutr, 2016, 5 (4) :358-371.
    [23]TANIGUCHI E, KAWAGUCHI T, ITOU M, et al.Subjective global assessment is not sufficient to screen patients with defective hepatic metabolism[J].Nutrition, 2011, 27 (3) :282-286.
    [24]SACKS GS, DEARMAN K, REPLOGLE WH, et al.Use of subjective global assessment to identify nutrition-associated complications and death in geriatric long-term care facility residents[J].J Am Coll Nutr, 2000, 19 (5) :570-577.
    [25]MORGAN MY, MADDEN AM, SOULSBY CT, et al.Derivation and validation of a new global method for assessing nutritional status in patients with cirrhosis?[J].Hepatology, 2006, 44 (4) :823-835.
    [26]KYLE UG, KOSSOVSKY MP, KARSEGARD VL, et al.Comparison of tools for nutritional assessment and screening at hospital admission:a population study[J].Clin Nutr, 2006, 25 (3) :409-417.
    [27]AMODIO P, BEMEUR C, BUTTERWORTH R, et al.The nutritional management of hepatic encephalopathy in patients with cirrhosis:International Society for Hepatic Encephalopathy and Nitrogen Metabolism Consensus[J].Hepatology, 2013, 58 (1) :325-336.
    [28]BORHOFEN SM, GERNER C, LEHMANN J, et al.The royal free hospital-nutritional prioritizing tool is an independent predictor of deterioration of liver function and survival in cirrhosis[J].Dig Dis Sci, 2016, 61 (6) :1735-1743.
    [29]YANG Y, WU YC, QI XL, et al.Value of RFH-NPT versus NRS-2002 in nutritional risk assessment for hospitalized patients with liver cirrhosis[J].Shaanxi Med J, 2016, 45 (12) :1661-1662. (in Chinese) 杨瑗, 吴宇超, 齐晓丽, 等.RFH-NPT与NRS-2002在肝硬化住院患者营养风险评估中的应用比较[J].陕西医学杂志, 2016, 45 (12) :1661-1662.
    [30]MONTANO-LOZA AJ, MEZA-JUNCO J, PRADO CM, et al.Muscle wasting is associated with mortality in patients with cirrhosis[J].Clin Gastroenterol Hepatol, 2012, 10 (2) :166-173.
    [31]MASUDA T, SHIRABE K, IKEGAMI T, et al.Sarcopenia is a prognostic factor in living donor liver transplantation[J].Liver Transpl, 2014, 20 (4) :401-407.
    [32]CRUZ-JENTOFT AJ, BAEYENS JP, BAUER JM, et al.Sarcopenia:European consensus on definition and diagnosis:Report of the European Working Group on Sarcopenia in Older People[J].Age Ageing, 2010, 39 (4) :412-423.
    [33]BELARMINO G, GONZALEZ MC, SALA P, et al.Diagnosing sarcopenia in male patients with cirrhosis by dual-energy X-ray absorptiometry estimates of appendicular skeletal muscle mass[J].JPEN J Parenter Enteral Nutr, 2017.[Epub ahead of print]
    [34]BEGINI P, GIGANTE E, ANTONELLI G, et al.Sarcopenia predicts reduced survival in patients with hepatocellular carcinoma at first diagnosis[J].2017, 16 (1) :107-114.
    [35]CAREY EJ, LAI JC, WANG CW, et al.A multicenter study to define sarcopenia in patients with end-stage liver disease[J].Liver Transpl, 2017, 23 (5) :625-633.
    [36]NARDELLI S, LATTANZI B, TORRISI S.Sarcopenia is risk factor for development of hepatic encephalopathy aftertransjugular intrahepatic portosysthemic shunt placement[J].Clin Gastroenterol Hepatol, 2017, 15 (6) :934-936.
    [37]KREYMANN KG, BERGER MM, DEUTZ NE, et al.ESPENguidelines on enteral nutrition:intensive care[J].Clin Nutr, 2006, 25 (2) :210-223.
    [38]ZHAO M.The research status of nutrition assessment and nutritional support in patients with cirrhosis[J].Chin J Gastroenterol Hepatol, 2015, 24 (7) :887-890. (in Chinese) 赵敏.肝硬化患者营养评价和营养支持的研究现状[J].胃肠病学和肝病学杂志, 2015, 24 (7) :887-890.
    [39]ZHANG YC, XIONG X.How to nutritional support for pediatric liver failure[J].Chin Pediatr Emerg Med, 2017, 24 (1) :13-16. (in Chinese) 张育才, 熊熙.肝功能衰竭患儿如何进行营养支持[J].中国小儿急救医学, 2017, 24 (1) :13-16.
    [40]TSIAOUSI ET, HATZITOLIOS AI, TRYGONIS SK, et al.Malnutrition in end stage liver disease:recommendations and nutritional support[J].J Gastroenterol Hepatol, 2008, 23 (4) :527-533.
    [41]TOSHIKUNI N, ARISAWA T, TSUTSUMI M.Nutrition and exercise in the management of liver cirrhosis[J].World J Gastroenterol, 2014, 20 (23) :7286-7297.
    [42]MILKE GARCA MP.Nutritional support in the treatment of chronic hepatic encephalopathy[J].Ann Hepatol, 2011, 10 (2) :s45-s49.
    [43]RAMOS FIGUEIRA ER, ROCHA FILHO JA, SOUTO NACIF L, et al.Nutritional support for fulminant hepatitis[J].Nutr Hosp, 2015, 32 (6) :2427-2432.
    [44]ZHANG QK, WANG ML.The management of perioperative nutrition in patients with end stage liver disease undergoing liver transplantation[J].Hepatobiliary Surg Nutr, 2015, 4 (5) :336-344.
    [45]FAN CL, WU YJ, DUAN ZP, et al.Resting energy expenditure and glucose, protein and fat oxidation in severe chronic virus hepatitis B patients[J].World J Gastroenterol, 2008, 14 (27) :4365-4369.
    [46] FAN C.Resting energy expenditure and glucose, protein and fat oxidation in severe chronic virus hepatitis B patients[J].World JGastroenterol, 2008, 14 (27) :4365.
    [47]LI CQ.Analysis of energy and protein metabolism and supply level of patients with liver cirrhosis[J].Chin Community Doct, 2015, 31 (35) :43-44. (in Chinese) 黎昌群.肝硬化能量和蛋白质代谢及供给水平分析[J].中国社区医师, 2015, 31 (35) :43-44.
    [48]ZHAO L, YE J, HOU XH.Progression of malnutrition diagnose and therapy in end stage liver disease[J].J Clin Intern Med, 2011, 28 (2) :80-83. (in Chinese) 赵莉, 叶进, 侯晓华.终末期肝病患者营养不良及营养治疗研究进展[J].临床内科杂志, 2011, 28 (2) :80-83.
    [49]MENG QH, LI XM.Malnutrition and nutrition support in patients of hepatocirrhosis[J].Parenter Enteral Nutr, 2006, 13 (5) :312-315. (in Chinese) 孟庆华, 李雪梅.肝硬化病人营养不良与营养支持[J].肠外与肠内营养, 2006, 13 (5) :312-315.
    [50]FENG ZJ.Effect of preoperative nutritional risk assessment and nutritional intervention on body composition in patients with liver cancer[D].Jinan:Shandong University, 2016. (in Chinese) 冯作静.肝癌患者术前营养风险评估及营养干预对体成分的影响[D].济南:山东大学, 2016.
    [51]MENG QH, LIU Y.Research advances in nutrition assessment and nutrition support therapy for severe hepatitis[J].Natl Med J China, 2007, 87 (18) :1290-1292. (in Chinese) 孟庆华, 刘娅.重型肝炎营养评价及营养支持治疗的研究进展[J].中华医学杂志, 2007, 87 (18) :1290-1292.
    [52]ARENDS J, BACHMANN P, BARACOS V, et al.ESPEN guidelines on nutrition in cancer patients[J].Clin Nutr, 2017, 36 (1) :11-48.
    [53]WANG BE, GAO Y.Nursing features of elderly patients lying in bed in department of internal medicine[J].Shanxi Med J, 2013, 42 (10) :1206-1207. (in Chinese) 王变娥, 高颖.浅谈内科长期卧床老年患者护理的特点[J].山西医药杂志, 2013, 42 (10) :1206-1207.
    [54]KONG M.The liver is nourished by midnight meal---Midnight meal brings benefits to patients with chronic liver diseases[J].Liver Doct, 2012, (5) :14-15. (in Chinese) 孔明.肝无夜餐不壮---慢性肝病患者夜间加餐益处多[J].肝博士, 2012, (5) :14-15.
    [55]NAKAYA Y, OKITA K, SUZUKI K, et al.BCAA-enriched snack improves nutritional state of cirrhosis[J].Nutrition, 2007, 23 (2) :113-120.
    [56]CHANG WK, CHAO YC, TANG HS, et al.Effects of extra-carbohydrate supplementation in the late evening on energy expenditure and substrate oxidation in patients with liver cirrhosis[J].JPEN JParenter Enteral Nutr, 1997, 21 (2) :96-99.
    [57]ZHAO JJ, ZHANG L.Selection of perioperative nutrition support therapy for patients with liver cancer[J/CD].Electr J Liver Tumor, 2014, 1 (1) :58-61. (in Chinese) 赵建军, 张磊.肝癌患者围手术期营养支持治疗的选择[J/CD].肝癌电子杂志, 2014, 1 (1) :58-61.
    [58]CONG MH, LI SL, LIU XH, et al.Effect of nutritional counseling combined with oral nutritional supplements on clinical outcome of esopha-geal cancer patients under radiotherapy treatment[J].Chin J Clin Nutr, 2016, 24 (2) :86-90. (in Chinese) 丛明华, 李淑娈, 刘雪辉, 等.营养咨询联合口服营养补充对食管癌放疗患者临床结局的影响[J].中华临床营养杂志, 2016, 24 (2) :86-90.
    [59]SHI HL, SHI HB, KONG M, et al.Compound nutrients promote liver rehabilitation and regeneration in rats with CCl4-induced liver cirrhosis[J].Chin J Cell Mol Immunol, 2013, 29 (12) :1237-1241. (in Chinese) 时红林, 时红波, 孔明, 等.复合营养素促进CCl4诱导的肝硬化大鼠肝脏的修复和再生[J].细胞与分子免疫学杂志, 2013, 29 (12) :1237-1241.
    [60]YONG W.Early enteral nutrition and ecoimmunonutrition in patients with primary liver cancer after hepatectomy[J].J Pract Hepatol, 2017, 20 (3) :328-332. (in Chinese) 雍伟.早期肠内免疫微生态营养对原发性肝癌患者术后临床疗效的影响[J].实用肝脏病杂志, 2017, 20 (3) :328-332.
    [61]LI JP, LU MJ.Perioperative nutritional therapy on liver cancer patients undergoing intervention[J/CD].Electr J Metabol Nutr Cancer, 2017, 4 (1) :21-25. (in Chinese) 李家平, 卢鸣剑.重视肝癌介入治疗围手术期患者的营养治疗[J/CD].肿瘤代谢与营养电子杂志, 2017, 4 (1) :21-25.
    [62]LI Q.Effect of early enteral nutrition on postoperative nutritional support in patients with primary liver cancer[J].J Qilu Nurs, 2016, 22 (2) :12-14. (in Chinese) 李倩.早期肠内营养对原发性肝癌患者术后营养支持效果的影响[J].齐鲁护理杂志, 2016, 22 (2) :12-14.
    [63]XUE YZ.Effect of early enteral nutrition on nutritional status and intestinal function after interventional therapy for liver cancer[J].Chin J Aesthet Med, 2012, 21 (18) :492-493. (in Chinese) 薛玉珠.早期肠内营养对肝癌介入术后机体营养状况及肠功能的影响[J].中国美容学杂志, 2012, 21 (18) :492-493.
    [64]YI JS, ZHANG JX, WANG J, et al.Malnutrition and nutritional therapy of hepatocellular carcinoma[J/CD].Electr J Metabol Nutr Cancer, 2015, 2 (3) :73-76. (in Chinese) 易佳盛, 张吉翔, 王静, 等.肝癌患者营养不良的原因及其营养治疗[J/CD].肿瘤代谢与营养电子杂志, 2015, 2 (3) :73-76.
    [65]YANG WX, ZHONG ZJ, CAO YJ, et al.Enteral nutrition support at early period used in patients with liver cancer after liver transplantation[J].Chin Clin Oncol, 2009, 14 (9) :827-830. (in Chinese) 阳文新, 钟正江, 曹耀军, 等.早期肠内营养支持在肝癌患者肝移植术后的应用[J].临床肿瘤学杂志, 2009, 14 (9) :827-830.
    [66]ASPEN Board of Directors and the Clinical Guidelines Task Force.Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients[J].JPEN J Parenter Enteral Nutr, 2002, 26 (1 Suppl) :1 sa-138 sa.
    [67]DROVER JW, CAHILL NE, KUTSOGIANNIS J, et al.Nutrition therapy for the critically ill surgical patient:we need to do better![J].JPEN J Parenter Enteral Nutr, 2010, 34 (6) :644-652.
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