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The management of perioperative nutrition in patients with end stage liver disease undergoing liver transplantation

机译:肝移植终末期肝病患者围手术期营养管理

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摘要

Malnutrition is found in almost 100% of patients with end stage liver disease (ESLD) awaiting transplantation and malnutrition before transplantation leads to higher rates of post-transplant complications and worse graft survival outcomes. Reasons for protein energy malnutrition include several metabolic alterations such as inadequate intake, malabsorption, and overloaded expenditure. And also, stress from surgery, gastrointestinal reperfusion injury, immunosuppressive therapy and corticosteriods use lead to delayed bowl function recovery and disorder of nutrients absorption. In the pretransplant phase, nutritional goals include optimization of nutritional status and treatment of nutrition-related symptoms induced by hepatic decompensation. During the acute post-transplant phase, adequate nutrition is required to help support metabolic demands, replenish lost stores, prevent infection, arrive at a new immunologic balance, and promote overall recovery. In a word, it is extremely important to identify and correct nutritional deficiencies in this population and provide an adequate nutritional support during all phases of liver transplantation (LT). This study review focuses on prevalence, nutrition support, evaluation, and management of perioperative nutrition disorder in patients with ESLD undergoing LT.
机译:在等待移植的终末期肝病(ESLD)患者中,几乎100%发现营养不良,并且在移植前营养不良会导致更高的移植后并发症发生率和较差的移植物存活结果。蛋白质能量营养不良的原因包括几种代谢改变,例如摄入不足,吸收不良和支出超支。而且,由于手术,胃肠道再灌注损伤,免​​疫抑制疗法和皮质类固醇激素的使用导致的压力导致碗功能恢复延迟和营养吸收障碍。在移植前阶段,营养目标包括优化营养状况和治疗由肝代偿失调引起的营养相关症状。在急性移植后阶段,需要足够的营养来帮助支持代谢需求,补充失去的存储,防止感染,达到新的免疫平衡并促进总体恢复。简而言之,在肝移植(LT)的所有阶段中,识别并纠正该人群的营养不足并提供足够的营养支持是极其重要的。这项研究的重点是患有LT的ESLD患者围手术期营养障碍的患病率,营养支持,评估和管理。

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