The Nebraska Medical Center, Omaha, Nebraska 68198-5400, USA.
Oncology (Williston Park). 2012 Jun;26(6):572-5, 580, 582 passim.
For decades, the concept of a neutropenic diet has implied a strict limitation of foods allowed for consumption, as a presumptive means of reducing the risk of infection in cancer patients. The rationale was to limit the introduction of potentially harmful bacteria into the gastrointestinal tract by the restriction of certain foods that might harbor those organisms. However, this concept has not been substantiated with direct proof, and no universal definition of the neutropenic diet exists. Exactly which foods are restricted varies greatly by institution, but most notable is the restriction of fresh fruits and vegetables. Research evaluating potential benefits of a neutropenic diet is very limited, but the diet is still prescribed in many institutions with the hope that it will prevent foodborne infection and/or bacteremia in neutropenic patients. Review of the pathophysiology of foodborne illness and pertinent studies about the neutropenic diet lead to the conclusion that there is no clear benefit from the longstanding dietary restrictions that may be imposed during neutropenia. Instead, we propose adoption of standard safe food handling methods to allow for a more liberalized diet in the neutropenic patient.
几十年来，营养学家一直认为，接受放化疗的肿瘤患者需要采用特殊的饮食方案，即所谓的“低渣饮食”，限制食用某些可能携带有害细菌的食物，从而减少感染的风险。这种方案的理论基础是通过限制某些食物的摄入来减少有害细菌进入胃肠道的机会。然而，这一概念并没有得到直接证据的支持，也没有关于“低渣饮食”的通用定义。具体限制哪些食物因机构而异，但最值得注意的是限制新鲜水果和蔬菜。关于“低渣饮食”潜在益处的研究非常有限，但许多机构仍在开具这种饮食方案，希望能预防中性粒细胞减少症患者的食源性感染和/或菌血症。通过对食源性疾病的病理生理学和相关研究的回顾，我们得出结论，在中性粒细胞减少症期间实施长期的饮食限制并没有明显的益处。相反，我们建议采用标准的安全食品处理方法，以便为中性粒细胞减少症患者提供更自由的饮食。
