Venegas Tresierra Luis Fernando, Holguín Marín Rosario, Yoza Yoshidaira Max, Mormontoy Lauret Wilfredo, Jara Cubas Teresa, Polo Ramírez Carmen, Vega Caico Ivonne
Medico Internista, Dpto. de Medicina del, HNERM.
Rev Gastroenterol Peru. 2002 Jan-Mar;22(1):13-8.
A nutritional evaluation was carried out in 43 cirrhotic outpatients who came to the Digestive Disease Department of the Edgardo Rebagliati Martins Hospital for a checkup. The evaluation included a dietary composition analysis; nutritional status through the analysis of lean and fatty mass through anthropometric parameters (tricipital skin fold thickness, midarm muscle circumference, muscle arm circumference and creatinine excretion in the 24 h urine/height ratio), measuring of visceral proteins (albumin, transferrin) and bioelectric Impedance. Finally, a nutritional dietary intervention was made according to international standards for cirrhotic patients. The Child - Pugh score was: Child A: 16 patients (37.1%), Child B: 20 patients (46.5%) and Child C: 7 patients (16.4%). The dietary analysis showed the following: Hypoprotein diets in 42 patients (98%), hypocaloric diets in 38 patients (88%), low fat diets in 36 patients (83.7%) only one patient had a normal diet. Nutritional status was normal in 15 patients (35%), 24 patients had protein malnutrition (56%) and 4 patients had protein-calorie malnutrition (9.3%). There was an association between Child B and C and the malnutrition diagnosis was (p = 0.045). The nutritional intervention was carried out in 19 of the 43 patients (dietary therapy) during 15 months; the results were 17 hospital admissions in the group without nutritional intervention and 6 in the group that had received nutritional intervention: (p = 0.01). Malnutrition and inadequate diets are becoming a prevalent problem in our cirrhotic population. Nutritional support may provide an additional and valuable therapy to decrease patient morbidity.
对43名前来埃德加多·雷巴利亚蒂·马丁斯医院消化内科进行检查的肝硬化门诊患者进行了营养评估。评估内容包括饮食成分分析;通过人体测量参数(三头肌皮褶厚度、上臂中部肌肉周长、上臂肌肉周长以及24小时尿肌酐排泄量与身高的比值)分析瘦体重和脂肪量来评估营养状况,测量内脏蛋白(白蛋白、转铁蛋白)以及生物电阻抗。最后,根据肝硬化患者的国际标准进行了营养饮食干预。Child-Pugh评分如下:Child A级:16例患者(37.1%),Child B级:20例患者(46.5%),Child C级:7例患者(16.4%)。饮食分析结果如下:42例患者(98%)为低蛋白饮食,38例患者(88%)为低热量饮食,36例患者(83.7%)为低脂饮食,只有1例患者饮食正常。15例患者(35%)营养状况正常,24例患者存在蛋白质营养不良(56%),4例患者存在蛋白质-热量营养不良(9.3%)。Child B级和C级与营养不良诊断之间存在关联(p = 0.045)。43例患者中有19例在15个月内接受了营养干预(饮食治疗);结果显示,未接受营养干预的组中有17例患者住院,接受营养干预的组中有6例患者住院:(p = 0.01)。营养不良和饮食不当正成为我们肝硬化患者群体中普遍存在的问题。营养支持可能为降低患者发病率提供一种额外且有价值的治疗方法。