Cleghorn Geoffrey
The School of Medicine, University of Queensland, Herston, Queensland 4006, Australia.
J Gastroenterol Hepatol. 2009 Oct;24 Suppl 3:S93-6. doi: 10.1111/j.1440-1746.2009.06078.x.
The advent of liver transplantation for end-stage liver disease (ESLD) in children has necessitated a major rethink in the preoperative preparation and management from simple palliative care to active directed intervention. This is particularly evident in the approach to the nutritional care of these patients with the historical understanding of the nutritional pertubations in ESLD being described from a single pediatric liver transplant center. ESLD in children is a hypermetabolic process adversely affecting nutritional status, metabolic, and non-metabolic body compartments. There is a complex dynamic process affecting metabolic activity within the metabolically active body cell mass, as well as lipid oxidation during fasting and at rest, with other factors operating in conjunction with daily activities. We have proposed that immediately ingested nutrients are a more important source of energy in patients with ESLD than in healthy children, among whom energy may be stored in various body compartments.
儿童终末期肝病（ESLD）肝移植的出现，使得术前准备和管理需要从简单的姑息治疗彻底转变为积极的定向干预。这在这些患者的营养护理方法中尤为明显，对ESLD营养紊乱的历史性认识是由一个儿科肝移植中心描述的。儿童ESLD是一个高代谢过程，会对营养状况、代谢和非代谢身体组成部分产生不利影响。存在一个复杂的动态过程，影响代谢活跃的体细胞群内的代谢活动，以及禁食和休息期间的脂质氧化，还有其他因素与日常活动共同作用。我们提出，与健康儿童相比，ESLD患者中即时摄入的营养物质是更重要的能量来源，健康儿童的能量可能储存在身体的各个部位。
