Tanaka Yoshiaki, Asakawa Takahiro, Saikusa Nobuyuki, Kojima Sinichiro, Koga Yoshinori, Hashizume Naoki, Iida Hitoshi, Yagi Minoru
Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan.
Nihon Geka Gakkai Zasshi. 2010 May;111(3):149-55.
The nutritional condition of perioperative patients affects the results of surgical treatment. For a better prognosis, surgeons must always consider patients' nutritional status preoperatively. After first assessing the nutritional status, a regimen to improve and/or maintain proper nutrition should be selected taking symptoms and treatment procedure into consideration. Peripheral parenteral nutrition provides limited energy. If patients' nutritional status requires improvement and they must fast for a long-term, total parenteral nutrition should be administered. Parenteral nutrition is nonphysiologic therapy and may have severe complications. During the administration of enteral nutrition via a gastrointestinal fistula or nasogastric tube, vomiting and incorrect infusion due to the improper positioning of the feeding tube may occur. When administering nutrition therapy via a gastrostomy or intestinal fistula, care must be taken to determine the appropriate dose and infusion rate. To provide suitable nutritional therapy, our knowledge of the various options available must be expanded.
围手术期患者的营养状况会影响手术治疗效果。为了获得更好的预后,外科医生必须始终在术前考虑患者的营养状况。在首先评估营养状况后,应根据症状和治疗程序选择改善和/或维持适当营养的方案。外周肠外营养提供的能量有限。如果患者的营养状况需要改善且必须长期禁食,则应给予全胃肠外营养。肠外营养是非生理性治疗,可能会有严重并发症。通过胃肠瘘或鼻胃管进行肠内营养时,可能会因喂养管位置不当而出现呕吐和输注错误。通过胃造口术或肠瘘进行营养治疗时,必须注意确定合适的剂量和输注速率。为了提供合适的营养治疗,我们必须扩展对各种可用选项的了解。