McCullough A J, Mullen K D, Smanik E J, Tabbaa M, Szauter K
Gastroenterology Unit, Case Western Reserve University, Cleveland Metropolitan General Hospital, Ohio.
Gastroenterol Clin North Am. 1989 Sep;18(3):619-43.
In terms of a general approach to these patients, the initial and most important step for the clinician is to have recognition and concern for the magnitude of malnutrition in patients with chronic liver disease. It is best to assume an inadequate diet and to have trained personnel review the individual's nutritional needs and design specific dietary regimens that supply sufficient energy and protein, perhaps in the form of frequent interval feedings. The currently available data support the use of specialized formulations only in selected patients with hepatic encephalopathy who are intolerant of an amount of protein sufficient to meet their nutritional requirements.
对于这些患者的一般治疗方法而言，临床医生最初且最重要的步骤是认识到并关注慢性肝病患者营养不良的严重程度。最好假定患者饮食不足，并安排专业人员评估个体的营养需求，设计能提供足够能量和蛋白质的特定饮食方案，或许可以采用少食多餐的形式。目前可得的数据支持仅在某些患有肝性脑病且无法耐受足以满足其营养需求的蛋白量的特定患者中使用特殊配方。
