Ng E H, Lowry S F
Department of Surgery, New York Hospital-Cornell Medical Center, New York.
Hematol Oncol Clin North Am. 1991 Feb;5(1):161-84.
Despite the widespread employment of intravenous feeding in patients with cancer cachexia to improve outcome, conflicting data exist regarding the efficacy of such therapy in addressing metabolic alterations secondary to immobility, malnutrition, and disease-specific processes. Persistence of distinct abnormalities of body and tissue integrity and peripheral tissue plasma inter-organ nitrogen flux imply the need for anabolic agents to enhance the therapeutic effects of parenteral nutrition. This article focuses upon potential anabolic agents such as chronic submaximal exercise, hormonal augmentation, pharmacologic intervention, and variations in substrate composition. Finally, the immunologic, metabolic, and endocrine consequences of bypassing the gastrointestinal tract are considered and related to the limited efficacy of current total parenteral nutrition regimens.
尽管静脉营养在癌症恶病质患者中广泛应用以改善预后，但关于这种疗法在解决因活动减少、营养不良和疾病特异性过程导致的代谢改变方面的疗效，存在相互矛盾的数据。身体和组织完整性以及外周组织血浆器官间氮通量持续存在明显异常，这意味着需要合成代谢剂来增强肠外营养的治疗效果。本文重点关注潜在的合成代谢剂，如慢性次最大运动、激素增强、药物干预以及底物组成的变化。最后，考虑了绕过胃肠道的免疫、代谢和内分泌后果，并将其与当前全肠外营养方案的有限疗效相关联。
