Department of Hepatobiliary Surgery, China-Japan Friendship Hospital, Beijing 100029, China.
Hepatobiliary Surg Nutr. 2014 Jun;3(3):140-8. doi: 10.3978/j.issn.2304-3881.2014.04.05.
The prevalence of liver dysfunction and malnutrition is common among patients with obstructive jaundice or cirrhosis, the poor nutrition status in patients with indications for hepatic resection increases the risk of postoperative complications and/or mortality. Hepatic surgery significantly affects body's metabolism and environment. Therefore, it is very important for patients with liver diseases undergoing hepatic surgery to receive essential nutritional support and fluid therapy during perioperative period. There are several principles in nutritional support and fluid therapy that surgeons need to pay attention to, for example, time, nutritional approach, fluid volume, choice of fat emulsions and amino acids. Some issues, such as albumin and plasma application, choice of crystalloid and colloid, liver protective therapy, also need further attention.
肝功能障碍和营养不良在阻塞性黄疸或肝硬化患者中很常见，有肝切除指征的患者营养状况较差会增加术后并发症和/或死亡率。肝切除术显著影响机体代谢和内环境。因此，对于接受肝切除术的肝病患者，在围手术期接受必要的营养支持和液体治疗非常重要。有几个原则需要外科医生注意，例如营养支持和液体治疗的时间、营养途径、液体量、脂肪乳剂和氨基酸的选择。白蛋白和血浆的应用、晶体和胶体的选择、肝保护治疗等问题也需要进一步关注。
