中国实用外科杂志 ›› 2012, Vol. 32 ›› Issue (02): 101-103.

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重视外科病人营养问题

李    宁   

  1. 南京军区南京总医院全军普通外科研究所 南京大学医学院临床学院,江苏南京210002
  • 出版日期:2012-02-01 发布日期:2012-01-18

  • Online:2012-02-01 Published:2012-01-18

摘要:

术前营养不良是影响手术预后的重要原因。老年外科病人增多使得外科营养问题更为突出,但外科医师的临床营养知识和对外科营养的重视程度仍有待提高。在加速康复外科模式下,围手术期营养的观念和原则也有了很大改变。临床证据表明,围手术期应用某些特殊营养底物具有抗炎、免疫调控和器官保护作用,并改善外科病人的预后,即“免疫营养”。外科营养的地位已从“营养支持”向“营养治疗”转变。

关键词: 营养治疗, 免疫营养, 加速康复外科

Abstract:

Focusing on nutrition in surgical patients        LI Ning. Research Institute of General Surgery, Nanjing General Hospital of Nanjing Military Command, Medical College of Nanjing University, Nanjing 210002,China
Abstract    Recognition of surgical patients with or at risk of malnutrition remains poor despite the availability of numerous clinical guidelines and clear evidence of the adverse effects of poor nutritional status on postoperative clinical outcomes. The practice of perioperative nutrition support has changed dramatically in the setting of fast-track surgery. In addition, extensive research has clearly shown that modifying the composition of standard nutritional regimen by adding supernormal doses of specific substrates such as arginine, glutamine and omega-3 fatty acid has immuno-modulatory, anti-inflammatory, anabolic and tissue protective ability, which often translates into improved surgical outcome. Therefore, the term “nutritional therapy” instead of “nutrition support” has been increasingly accepted in the era of immunonutrition.

Key words: nutritional therapy, immunonutrition, fast-track surgery