Lochs H, Plauth M
Medizinische Klinik mit Schwerpunkt Gastroenterologie, Hepatologie und Endokrinologie Universitätsklinikum Charité, Berlin, Germany.
Curr Opin Clin Nutr Metab Care. 1999 Jul;2(4):345-9. doi: 10.1097/00075197-199907000-00017.
Evaluation of nutritional status is a major problem in patients with liver cirrhosis this is due to water retention and the effect of liver function on protein synthesis. Despite problems evaluating the patient, malnutrition has been found to be a common complication in liver cirrhosis and is associated with poorer outcome. Nutritional restrictions, like protein restriction, are no longer recommended in most patients with liver cirrhosis but are considered harmful. An intake of 1 to 1.5 g/kg protein and 25 to 40 kcal/kg body weight a day is recommended (depending on the situation of the patient). If adequate intake cannot be achieved by oral nutrition, stepwise nutritional support with the introduction of an additional late evening meal, sip feeding or tube feeding is recommended. Parenteral nutrition should be used as a second line treatment for acutely ill patients. Data indicate that improvement of nutritional status prior to liver transplantation might reduce complications.
评估营养状况是肝硬化患者面临的一个主要问题，这是由于水潴留以及肝功能对蛋白质合成的影响。尽管评估患者存在问题，但营养不良已被发现是肝硬化常见的并发症，且与较差的预后相关。在大多数肝硬化患者中，不再推荐诸如蛋白质限制等营养限制措施，而是认为这些措施有害。建议每日摄入1至1.5克/千克蛋白质以及25至40千卡/千克体重（具体取决于患者情况）。如果通过口服营养无法实现足够的摄入量，建议逐步进行营养支持，包括增加一顿深夜加餐、小口喂食或管饲。肠外营养应用于急性病患者的二线治疗。数据表明，肝移植前营养状况的改善可能会减少并发症。
