Naber A H
Dept. of Gastroenterology, University Hospital Nijmegen, The Netherlands.
Scand J Gastroenterol Suppl. 1991;188:118-23. doi: 10.3109/00365529109111239.
In this article the general guidelines for a nutrition schedule and new developments in the field of parenteral nutrition are discussed. The present possibilities for parenteral nutrition do not imitate the normal physiologic diet completely. The most frequently used calculation of the energy expenditure is estimated by a formula using weight, height, and age and was developed in healthy persons. It does not always represent the real caloric demands of a patient. Complications, partly due to parenteral nutrition, are noted. In severely ill patients hyperglycaemia and liver function disorders are frequently observed. Parenteral nutrition results in atrophy of the intestinal mucosa. Deficiencies in trace elements and vitamins are diagnosed despite calculated adequate nutritional support because the demands are underestimated. New developments in parenteral nutrition include a better method to determine the nutritional demands in clinical practice, administration of hormones to improve the nitrogen balance, and development of new lipid emulsions and amino-acid solutions. Studies provide more insight into the physiologic process of trace element metabolism, and methods are being developed to define a real deficiency.
本文讨论了营养方案的一般指南以及肠外营养领域的新进展。目前肠外营养的可能性并不能完全模拟正常的生理饮食。最常用的能量消耗计算方法是通过一个使用体重、身高和年龄的公式估算出来的，该公式是针对健康人开发的。它并不总是代表患者的实际热量需求。文中指出了部分由肠外营养引起的并发症。在重症患者中，经常观察到高血糖和肝功能障碍。肠外营养会导致肠黏膜萎缩。尽管计算出的营养支持充足，但仍诊断出微量元素和维生素缺乏，因为需求被低估了。肠外营养的新进展包括在临床实践中确定营养需求的更好方法、使用激素改善氮平衡以及开发新的脂质乳剂和氨基酸溶液。研究对微量元素代谢的生理过程有了更多了解，并且正在开发定义真正缺乏的方法。
