Popovici Paula, Moraru Evelina
Clinica a II-a Pediatrie, Facultatea de Medicină, Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi.
Rev Med Chir Soc Med Nat Iasi. 2010 Jul-Sep;114(3):726-30.
Plurietiological hepatic cholestasis involves an increased risk of protein-caloric malnutrition and specifical nutritional deficiencies. Biological investigations to determine deficiencies in fat-soluble vitamins are essential for specific nutritional therapy . Although malnutrition is not an absolute contraindication for liver transplantation, its gravity has complex consequences in relation to this intervention.
The authors present a study conducted over a period of 5 years following the analysis of 293 children diagnosed with intra- or extrahepatic abnormalities that caused varying degrees of cholestasis.
In the study group, the percentage of infants with cholestasis was 45.39% (133 cases) and among them 62.12% had malnutrition (82 children). Clinical evaluation of fat-soluble vitamins deficiency, in particular, but also of the soluble and minerals was performed in all patients. Liver transplantation was successfully performed in three cases.
Most important factors affecting growth after transplantation were age at the time of the liver transplant and primary diagnosis that required transplant. The role of nutritional support prior to liver transplantation is of great importance. Quality nutritional support change impact that malnutrition has on survival after liver transplantation.
多病因性肝内胆汁淤积症会增加蛋白质 - 热量营养不良及特定营养缺乏症的风险。进行生物学检查以确定脂溶性维生素缺乏情况对于特定营养治疗至关重要。尽管营养不良并非肝移植的绝对禁忌证,但其严重程度与该干预措施存在复杂的关联后果。
作者对293名被诊断患有肝内或肝外异常导致不同程度胆汁淤积的儿童进行了为期5年的研究分析。
在研究组中,胆汁淤积婴儿的比例为45.39%(133例),其中62.12%存在营养不良(82名儿童)。对所有患者进行了脂溶性维生素缺乏的临床评估,特别是水溶性维生素和矿物质缺乏的评估。3例患者成功进行了肝移植。
影响移植后生长的最重要因素是肝移植时的年龄以及需要移植的初始诊断。肝移植前营养支持的作用至关重要。优质的营养支持会改变营养不良对肝移植后生存的影响。