Wolk R A, Rayburn W F
Nutr Clin Pract. 1990 Aug;5(4):139-52. doi: 10.1177/0115426590005004139.
PN is required to maintain or restore an anabolic state when oral enteral routes are not feasible. Despite 22 years of experience with PN, its use during pregnancy has only recently been reported. Most of this information is anecdotal but suggests that this mode of therapy is safe, effective, and occasionally lifesaving. PN during pregnancy has been used most often to provide adequate nutrition for those who suffer from prolonged hyperemesis or who have difficulty absorbing adequate nutrients because of such conditions as Crohn's disease. The proper selection and administration of dextrose, fat, protein, vitamins, trace elements, and electrolytes for pregnant women have been associated with favorable perinatal outcomes. Fat emulsion use does not appear to be associated with any abnormal outcomes. Preterm deliveries and intrauterine fetal growth retardation appear to relate to preexisting or coexisting medical or obstetric complications. Principles for PN with all patients would apply during pregnancy. As with any therapy, the benefits must be weighed against the risks and costs. Sufficient favorable clinical experience over the last 10 years suggests that PN is a relatively safe and effective method for reversing maternal malnutrition and promoting normal fetal growth and development.
当口服肠内途径不可行时，需要肠外营养（PN）来维持或恢复合成代谢状态。尽管有22年使用PN的经验，但直到最近才报道了其在孕期的应用。这些信息大多是轶事性的，但表明这种治疗方式是安全、有效的，偶尔还能挽救生命。孕期PN最常用于为患有持续性妊娠剧吐或因克罗恩病等疾病而难以吸收足够营养的患者提供充足营养。为孕妇正确选择和使用葡萄糖、脂肪、蛋白质、维生素、微量元素和电解质与良好的围产期结局相关。使用脂肪乳剂似乎与任何异常结局无关。早产和宫内胎儿生长受限似乎与既往存在或并存的内科或产科并发症有关。对所有患者进行PN的原则在孕期同样适用。与任何治疗一样，必须权衡其益处与风险和成本。过去10年中足够多的良好临床经验表明，PN是一种相对安全有效的方法，可用于扭转母体营养不良并促进胎儿正常生长发育。
