Parenteral nutrition associated cholestasis ( PNAC) develops in patients who require long-term parenteral nutrition ( PN) for intestinal failure. The clinical spectrum includes hepatic steatosis, cholestasis, cholelithiasis and hepatic fibrosis. The pathogenesis of PNAC is multifactorial and is related to infection, long-term PN, lack of enteral stimulation and short bowel syndrome. Management strategies for prevention of PNAC include reverting to enteral feeding as early as possible, preventing infection, improving the method of PN, promoting gallbladder contraction and antioxidant therapy. A multidisciplinary approach to management of PN with a specialized nutritional support team can reduce the morbidity of PNAC.%肠外营养相关胆汁淤积(PNAC)多发生在由于肠功能衰竭而需长期接受肠外营养支持的患者,临床表现主要包括肝脏脂肪变性、胆汁淤积、胆石症以及肝纤维化.PNAC由多种因素引起,如感染、长期肠外营养支持、缺乏肠道刺激和短肠综合征等.预防肠外营养相关肝脏疾病的策略是尽早开始肠内营养、防治感染、改善肠外营养方案、促进胆囊收缩和抗氧化剂治疗等.由营养支持小组进行营养管理,可减少PNAC的发生.
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