Bolder U, Ebener C, Hauner H, Jauch K W, Kreymann G, Ockenga J, Traeger K
Dept. of Surgery, University of Regensburg, Germany.
Ger Med Sci. 2009 Nov 18;7:Doc23. doi: 10.3205/000082.
The main role of carbohydrates in the human body is to provide energy. Carbohydrates should always be infused with PN (parenteral nutrition) in combination with amino acids and lipid emulsions to improve nitrogen balance. Glucose should be provided as a standard carbohydrate for PN, whereas the use of xylite is not generally recommended. Fructose solutions should not be used for PN. Approximately 60% of non-protein energy should be supplied as glucose with an intake of 3.0-3.5 g/kg body weight/day (2.1-2.4 mg/kg body weight/min). In patients with a high risk of hyperglycaemia (critically ill, diabetes, sepsis, or steroid therapy) an lower initial carbohydrate infusion rate of 1-2 g/kg body weight/day is recommended to achieve normoglycaemia. One should aim at reaching a blood glucose level of 80-110 mg/dL, and at least a glucose level <145 mg/dL should be achieved to reduce morbidity and mortality. Hyperglycaemia may require addition of an insulin infusion or a reduction (2.0-3.0 g/kg body weight/day) or even a temporary interruption of glucose infusion. Close monitoring of blood glucose levels is highly important.
碳水化合物在人体中的主要作用是提供能量。碳水化合物应始终与氨基酸和脂肪乳剂联合用于肠外营养（PN），以改善氮平衡。葡萄糖应作为PN的标准碳水化合物提供，而一般不推荐使用木糖醇。果糖溶液不应用于PN。约60%的非蛋白质能量应以葡萄糖形式提供，摄入量为3.0 - 3.5克/千克体重/天（2.1 - 2.4毫克/千克体重/分钟）。对于有高血糖风险的患者（重症患者、糖尿病患者、脓毒症患者或接受类固醇治疗的患者），建议初始碳水化合物输注速率较低，为1 - 2克/千克体重/天，以实现血糖正常。目标应是使血糖水平达到80 - 110毫克/分升，并且至少应达到血糖水平<145毫克/分升，以降低发病率和死亡率。高血糖可能需要添加胰岛素输注或减少（2.0 - 3.0克/千克体重/天）甚至暂时中断葡萄糖输注。密切监测血糖水平非常重要。
