Center for the Study of Nutrition Medicine, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Feldberg 880 East Campus, 330 Brookline Avenue, Boston, MA 02215, USA.
Surg Clin North Am. 2011 Jun;91(3):467-80. doi: 10.1016/j.suc.2011.03.001. Epub 2011 Apr 29.
Metabolic changes after surgery, trauma, or serious illness have a complex pathophysiology. The early posttraumatic stress response is physiologic and associated with a state of hyperinflammation, increased oxygen consumption, and increased energy expenditure. These are part of a systemic reaction that encompasses a wide range of endocrinological, immunologic, and hematological effects. Surgery initiates changes in metabolism that can affect virtually all organs and tissues; the metabolic response results in hormone-mediated mobilization of endogenous substrates that leads to stress catabolism. Hypercatabolism has been associated with severe complications related to hyperglycemia, hypoproteinemia, and immunosuppression. Proper metabolic support is essential to restore homeostasis and ensure survival.
手术后、创伤后或重病后代谢的变化具有复杂的病理生理学。创伤后早期应激反应是生理性的，与炎症反应亢进、耗氧量增加和能量消耗增加有关。这些都是全身性反应的一部分，包括广泛的内分泌、免疫和血液学效应。手术会引发代谢变化，几乎可以影响所有器官和组织；代谢反应导致激素介导的内源性底物动员，进而导致应激分解代谢。过度分解代谢与与高血糖、低蛋白血症和免疫抑制相关的严重并发症有关。适当的代谢支持对于恢复内环境稳定和确保生存至关重要。
