外科血液净化病人的营养治疗被引量：2

Nutrition support in surgical patients on continuous renal replacement therapy

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摘要外科病人在围术期合并急性肾损伤会带来治疗的难度及增加病死率。对这类病人进行营养治疗虽有必要,但难度很大。持续肾脏替代治疗除了能为外科重症病人提供器官功能的支持外,由于可主动调节病人的进出容量,因而使这类病人的营养治疗成为可能。外科血液净化病人多存在蛋白质能量营养不良,其代谢率的增高与基础疾病及基础营养状态有关。营养治疗宜从小量开始,营养素全面,并兼顾合适的热氮比,保证足够的氮摄入量,应该将持续床边血液净化治疗(continuous renal replacement therapy,CRRT)对机体氮、糖类、电解质、微量营养素的清除考虑在内,适当补充一些肾功能障碍时可能有益的营养素,如左旋卡尼汀、谷氨酰胺、鱼油脂肪乳剂等。外科血液净化病人的营养治疗途径仍首选经口或肠内营养,即使在开始治疗时需选用肠外营养,也应将最终能够经口或经肠道内营养方式作为治疗的目标。 Acute kidney injury （AKI） which often occurrs in perioperative surgical patients may lead to death and result in therapy dilema. Patients with AKI have always protein-energy malnutrition and need appropriate nutrition support. Continuous renal replacement therapy （CRRT） makes it possible to bring nutrients and fluid to patients but also affects the metabolism of AKI patients. Nitrogen intake should be enough to get positive nitrogen balance and , some micronutrients and agents, such as 1-carnitine, glutamine, intralipid and so on, are also indispensible. Oral or enteral nutrition is the first choice. Parenteral nutrition is always necessary to fullfil the aim of nutrition.

作者朱然马晓春

机构地区中国医科大学附属第一医院重症医学科

出处《中国实用外科杂志》 CSCD 北大核心 2010年第11期930-932,共3页 Chinese Journal of Practical Surgery

关键词血液净化急性肾损伤营养治疗 blood purification acute kidney injury nutrition therapy

分类号 R6 [医药卫生—外科学]

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参考文献9

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