Nightingale Scott, Ng Vicky Lee
SickKids Transplant Center, Division of Gastroenterology, Hepatology, and Nutrition, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.
Pediatr Clin North Am. 2009 Oct;56(5):1161-83. doi: 10.1016/j.pcl.2009.06.005.
Malnutrition is common in infants and children with chronic liver disease (CLD) and may easily be underestimated by clinical appearance alone. The cause of malnutrition in CLD is multifactorial, although insufficient dietary intake is probably the most important factor and is correctable. Fat malabsorption occurs in cholestatic disorders, and one must also consider any accompanying fat-soluble vitamin and essential fatty acid deficiencies. The clinician should proactively evaluate, treat, and re-evaluate response to treatment of nutritional deficiencies. Because a better nutritional state is associated with better survival before and after liver transplantation, aggressive nutritional management is an important part of the care of these children.
营养不良在患有慢性肝病（CLD）的婴幼儿中很常见，仅通过临床表现很容易被低估。CLD中营养不良的原因是多因素的，尽管饮食摄入不足可能是最重要的因素且是可纠正的。脂肪吸收不良发生在胆汁淤积性疾病中，还必须考虑任何伴随的脂溶性维生素和必需脂肪酸缺乏情况。临床医生应积极评估、治疗并重新评估营养缺乏症的治疗反应。由于更好的营养状态与肝移植前后更好的生存率相关，积极的营养管理是这些儿童护理的重要组成部分。
