肝硬化患者营养评价和营养支持的研究现状
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摘要
为掌握肝硬化患者营养评价和营养支持的研究现状,该文对国内外各学者的研究成果进行了分析与整理。首先分析了肝硬化患者营养不良的原因,继而阐述了常用的营养评价方法。重点从西医与中医两个角度出发,对肝硬化患者的营养支持现状进行总结。通过对各学者研究成果的观察,证实了各项营养评估及支持方法的临床应用价值。
In order to grasp the research status of nutrition evaluation and nutritional support in patients with liver cirrhosis, this paper analyzes and organizes the research results of scholars at home and abroad. Firstly, the causes of malnutrition in patients with cirrhosis were analyzed, and then the commonly used nutritional evaluation methods were described. Focusing on the two aspects of Western medicine and Chinese medicine, the status of nutritional support for patients with cirrhosis was summarized. Through the observation of the research results of various scholars, the clinical application value of various nutritional assessment and support methods was confirmed.
In order to grasp the research status of nutrition evaluation and nutritional support in patients with liver cirrhosis, this paper analyzes and organizes the research results of scholars at home and abroad. Firstly, the causes of malnutrition in patients with cirrhosis were analyzed, and then the commonly used nutritional evaluation methods were described. Focusing on the two aspects of Western medicine and Chinese medicine, the status of nutritional support for patients with cirrhosis was summarized. Through the observation of the research results of various scholars, the clinical application value of various nutritional assessment and support methods was confirmed.
引文
[1]Maharshi S,Sharma BC,Srivastava S.Malnutrition in cirrhosis increases morbidity and mortality[J].J Gastroenterol Hep atol,2015,30(10):1507-1513.
[2]Sareh E,Hossein P,Reza M.Malnutrition in liver cirrhosis the influence of protein and Sodium[J].Mid East J Digest Dis,2013,5(2):65-75.
[3]Fialla AD,Israelsen M,Hamberg O,et al.Nutritional therapy in cirrhosis or alcoholic hepatitis:a systematic review and meta-analysis[J].Liver Int,2015.doi:10.1111/liv.12798.
[4]FA Giannone,P Caraceni.Inadequate Nutrition in Patients with Cirrhosis:The Need of a Personalized Educational Program[J].Journal of Hepatology,2016,64(2):10.
[5]胡翔,贺德,王庐荆.微生态营养对肝硬化肝部分切除大鼠肠黏膜机械屏障的保护作用[J].齐齐哈尔医学院学报2017,38(21):2485-2489.
[6]班凌伟,于淑清,华鑫.酒精性肝硬化和病毒性肝硬化病人营养状况调查和分析[J].肠外与肠内营养,2017,24(2)105-108.
[7]朱鸣,赵长清,平健,等.肝硬化患者营养风险筛查路径的探讨[J].中华肝脏病杂志,2016,24(3):225-227.
[8]史志红,周晓,班志芬.乙型肝炎肝硬化与酒精性肝硬化患者营养状况评估分析[J].实用肝脏病杂志,2018,21(4)629-630.
[9]曹平,姚佳,朱娜.肌肉减少症评价肝硬化患者营养状况及其影响因素[J].中国药物与临床,2017,17(12):1737-1739.
[10]Kyle UG,Genton L,Pichard C.Low phase angle determined by bioelectrical impedance analysis is associated with malnutrition and nutritional risk at hospital admission[J].Clin Nutr,2013,32(2):294-299.
[11]Moctezuma-Velázquez C,García-Juárez I,Soto-Solís R,et al.Nutritional assessment and treatment of patients with liver cirrhosis[J].Nutrition,2013,29(11-12):1279-1285.
[12]杨瑗,吴宇超,齐晓丽.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.
[13]胡弘毅,朱琴梅,王甦.肝硬化患者营养状况影响因素与评估方法研究[J].胃肠病学和肝病学杂志,2015,24(8)1026-1029.
[14]Plauth M,CabréE,Campillo B,et al.ESPEN guidelines on parenteral nutrition:hepatology[J].Clin Nutr,2009,28(4)436-444.
[15]梁明霞.拉米夫定联合合理营养规划治疗失代偿期乙型肝炎肝硬化临床观察[J].北方药学,2016,13(6):108-109.
[16]刁建辉,史增玉,魏瑞雪.对存在营养风险的老年肝硬化患者使用营养干预的效果评价[J].中国老年保健医学2016,14(6):87-88.
[17]Tsuda Y,Fukui H,Sujishi T,et al.Is administrating branched-chain amino acid-enriched nutrition achieved symptom-free in malnourished cirrhotic patients?[J].JClin Biochem Nutr,2014,54(1):51-54.
[18]蔡柏奇,许舒婷.肠内营养支持联合谷氨酰胺在改善失代偿期肝硬化患者肝功能、营养状况及肠屏障功能中的作用[J].吉林医学,2018,39(4):645-646.
[19]王剑彬,吴彩月,王丽斯.低热量肠内营养支持对肝癌合并肝硬化患者术后康复及免疫功能的影响[J].中国肿瘤临床与康复,2018,25(1):51-54.
[20]封育瑾.整蛋白型肠内营养支持对乙型肝炎后肝硬化继发营养不良患者Child-Pugh分级及营养状态的影响[J].现代实用医学,2017,29(7):854-856.
[21]林双双,张文青,李小玲.强化支链氨基酸和谷氨酰胺的肠内营养支持对肝硬化病人的治疗作用[J].肠外与肠内营养,2016,23(6):354-357.
[22]蒋仁秀,王艳,汤海燕.纽娃肝营养素在肝硬化患者营养支持中的效果观察[J].当代护士,2017,16(2中旬刊)159-160.
[23]李晓明,蔺洁,李尧.1例肝硬化合并上消化道出血患者肠外营养支持的药学监护[J].中国药房,2017,28(32)4569-4571.
[24]符辉.对失代偿期肝硬化患者进行肠外营养支持治疗的效果分析[J].当代医药论丛,2016,14(16):74-75.
[25]唐彪,欧阳正晟.合并肝硬化的原发性肝癌患者术后三种肠外营养支持方案的效果比较[J].肝胆胰外科杂志2015,27(2):149-152.
[26]王秀珍,周菊,王晓霖.个性化心理护理对失代偿期肝硬化患者营养状态的影响分析[J].现代消化及介入诊疗2017,22(5):719-721.
[27]黄振强,郑海雅,曲春生.肝硬化合并感染患者营养状况及免疫功能检测结果分析[J].中国卫生检验杂志2018,28(4):473-475.
[28]杨碧霜,郑文龙,陈丽新.自拟食疗方改善肝硬化失代偿期患者营养状况的评价[J].中国肝脏病杂志:电子版2016,8(4):94-96.
[29]刘诗泆.黄芪四君子汤联合不同营养方式对肝硬化肝癌大鼠肝部分切除术后营养状态与免疫功能的影响[J]中国老年学杂志,2016,36(23):5807-5809.
[30]陈凯生,刘铭,魏卓红.软肝煎加减方联合药膳治疗肝硬化腹水合并营养不良临床研究[J].新中医,2017,49(7)58-60.
[31]费景兰,郭敏,顾亚娇.基于肝病实脾理论研究夜间加餐对肝硬化失代偿期患者营养状态的影响[J].中西医结合肝病杂志,2017,27(3):144-145,148.
[2]Sareh E,Hossein P,Reza M.Malnutrition in liver cirrhosis the influence of protein and Sodium[J].Mid East J Digest Dis,2013,5(2):65-75.
[3]Fialla AD,Israelsen M,Hamberg O,et al.Nutritional therapy in cirrhosis or alcoholic hepatitis:a systematic review and meta-analysis[J].Liver Int,2015.doi:10.1111/liv.12798.
[4]FA Giannone,P Caraceni.Inadequate Nutrition in Patients with Cirrhosis:The Need of a Personalized Educational Program[J].Journal of Hepatology,2016,64(2):10.
[5]胡翔,贺德,王庐荆.微生态营养对肝硬化肝部分切除大鼠肠黏膜机械屏障的保护作用[J].齐齐哈尔医学院学报2017,38(21):2485-2489.
[6]班凌伟,于淑清,华鑫.酒精性肝硬化和病毒性肝硬化病人营养状况调查和分析[J].肠外与肠内营养,2017,24(2)105-108.
[7]朱鸣,赵长清,平健,等.肝硬化患者营养风险筛查路径的探讨[J].中华肝脏病杂志,2016,24(3):225-227.
[8]史志红,周晓,班志芬.乙型肝炎肝硬化与酒精性肝硬化患者营养状况评估分析[J].实用肝脏病杂志,2018,21(4)629-630.
[9]曹平,姚佳,朱娜.肌肉减少症评价肝硬化患者营养状况及其影响因素[J].中国药物与临床,2017,17(12):1737-1739.
[10]Kyle UG,Genton L,Pichard C.Low phase angle determined by bioelectrical impedance analysis is associated with malnutrition and nutritional risk at hospital admission[J].Clin Nutr,2013,32(2):294-299.
[11]Moctezuma-Velázquez C,García-Juárez I,Soto-Solís R,et al.Nutritional assessment and treatment of patients with liver cirrhosis[J].Nutrition,2013,29(11-12):1279-1285.
[12]杨瑗,吴宇超,齐晓丽.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.
[13]胡弘毅,朱琴梅,王甦.肝硬化患者营养状况影响因素与评估方法研究[J].胃肠病学和肝病学杂志,2015,24(8)1026-1029.
[14]Plauth M,CabréE,Campillo B,et al.ESPEN guidelines on parenteral nutrition:hepatology[J].Clin Nutr,2009,28(4)436-444.
[15]梁明霞.拉米夫定联合合理营养规划治疗失代偿期乙型肝炎肝硬化临床观察[J].北方药学,2016,13(6):108-109.
[16]刁建辉,史增玉,魏瑞雪.对存在营养风险的老年肝硬化患者使用营养干预的效果评价[J].中国老年保健医学2016,14(6):87-88.
[17]Tsuda Y,Fukui H,Sujishi T,et al.Is administrating branched-chain amino acid-enriched nutrition achieved symptom-free in malnourished cirrhotic patients?[J].JClin Biochem Nutr,2014,54(1):51-54.
[18]蔡柏奇,许舒婷.肠内营养支持联合谷氨酰胺在改善失代偿期肝硬化患者肝功能、营养状况及肠屏障功能中的作用[J].吉林医学,2018,39(4):645-646.
[19]王剑彬,吴彩月,王丽斯.低热量肠内营养支持对肝癌合并肝硬化患者术后康复及免疫功能的影响[J].中国肿瘤临床与康复,2018,25(1):51-54.
[20]封育瑾.整蛋白型肠内营养支持对乙型肝炎后肝硬化继发营养不良患者Child-Pugh分级及营养状态的影响[J].现代实用医学,2017,29(7):854-856.
[21]林双双,张文青,李小玲.强化支链氨基酸和谷氨酰胺的肠内营养支持对肝硬化病人的治疗作用[J].肠外与肠内营养,2016,23(6):354-357.
[22]蒋仁秀,王艳,汤海燕.纽娃肝营养素在肝硬化患者营养支持中的效果观察[J].当代护士,2017,16(2中旬刊)159-160.
[23]李晓明,蔺洁,李尧.1例肝硬化合并上消化道出血患者肠外营养支持的药学监护[J].中国药房,2017,28(32)4569-4571.
[24]符辉.对失代偿期肝硬化患者进行肠外营养支持治疗的效果分析[J].当代医药论丛,2016,14(16):74-75.
[25]唐彪,欧阳正晟.合并肝硬化的原发性肝癌患者术后三种肠外营养支持方案的效果比较[J].肝胆胰外科杂志2015,27(2):149-152.
[26]王秀珍,周菊,王晓霖.个性化心理护理对失代偿期肝硬化患者营养状态的影响分析[J].现代消化及介入诊疗2017,22(5):719-721.
[27]黄振强,郑海雅,曲春生.肝硬化合并感染患者营养状况及免疫功能检测结果分析[J].中国卫生检验杂志2018,28(4):473-475.
[28]杨碧霜,郑文龙,陈丽新.自拟食疗方改善肝硬化失代偿期患者营养状况的评价[J].中国肝脏病杂志:电子版2016,8(4):94-96.
[29]刘诗泆.黄芪四君子汤联合不同营养方式对肝硬化肝癌大鼠肝部分切除术后营养状态与免疫功能的影响[J]中国老年学杂志,2016,36(23):5807-5809.
[30]陈凯生,刘铭,魏卓红.软肝煎加减方联合药膳治疗肝硬化腹水合并营养不良临床研究[J].新中医,2017,49(7)58-60.
[31]费景兰,郭敏,顾亚娇.基于肝病实脾理论研究夜间加餐对肝硬化失代偿期患者营养状态的影响[J].中西医结合肝病杂志,2017,27(3):144-145,148.