关键词: 围手术期, 补充性肠外营养, 肠内营养

Abstract:

Perioperative supplementary parenteral nutrition support therapy        ZHU Ming-wei.Department of General Surgery, Beijing Hospital, National Center for Geriatrics, Beijing 100730，China
Abstract    The incidence of malnutrition is high in surgical patients. Inadequate intake and gastrointestinal dysfunction are the main causes, which can lead to increased postoperative complications and prolonged hospitalization. Standardized nutritional support can improve the clinical outcome. Enteral nutrition is preferred as perioperative support to protect the intestinal barrier and immune function. Intolerance is the main reason of enteral nutrition which is difficult to implement. The insufficient supply of energy and protein for longer periods of time can lead to increased mortality and complications. The combined with PN on the basis of EN is the core of parenteral nutrition which is to maintain intestinal barrier function, quickly reach the target amount to meet the metabolic needs and improve the clinical outcome. The target patient of perioperative parenteral nutrition is that enteral nutrition can not provide more than 60% energy needs. The start of enteral nutrition in patients with low nutrition risk (NRS2002 ≤３or Nutric score ≤ 5 ) will start after 7 days; and start at 48-72 hours after operation for high preoperative nutritional risk (NRS2002 ≥5 or Nutric score≥6). Supplement of parenteral nutrition with glutamine and ω-3 fatty acids can optimize the clinical outcomes of surgical patients. The application of multichamber bags can reduce bloodstream infections and is suitable for short-term supplementary parenteral nutrition after surgery.

Key words: perioperative, supplementary parenteral nutrition, enteral nutrition