特定疾病的营养疗法：并非一概而论。
Disease-specific nutrition therapy: one size does not fit all.
作者信息
Yeh D D, Velmahos G C
机构信息
Department of Surgery, Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, 165 Cambridge St. #810, MA, 02114, USA.
Division Chief of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge St. #810, Boston, MA, USA.
出版信息
Eur J Trauma Emerg Surg. 2013 Jun;39(3):215-33. doi: 10.1007/s00068-013-0264-8. Epub 2013 Feb 25.
INTRODUCTION
The delivery of adequate nutrition is an integral part of the care of the critically ill surgical patient, and the provision of nutrition may have a greater impact on outcome than many other therapies commonly employed in the treatment of certain disease states.
METHODS
A review of the existing literature was performed to summarize the evidence for utilizing disease-specific nutrition in critically ill surgical patients.
RESULTS
Enteral nutrition, unless specifically contraindicated, is always preferable to parenteral nutrition. Methodological heterogeneity and conflicting results plague research in immunonutrition, and routine use is not currently recommended in critically ill patients.
CONCLUSION
There is currently insufficient evidence to recommend the routine initial use of most disease-specific formulas, as most patients with the disease in question will tolerate standard enteral formulas. However, the clinician should closely monitor for signs of intolerance and utilize disease-specific formulas when appropriate.
引言
提供充足营养是重症外科患者护理的一个组成部分，并且在某些疾病状态的治疗中，营养供给对治疗结果的影响可能比许多其他常用疗法更大。
方法
对现有文献进行综述，以总结在重症外科患者中使用特定疾病营养的证据。
结果
除非有明确禁忌，肠内营养始终优于肠外营养。免疫营养研究存在方法学异质性和相互矛盾的结果，目前不建议在重症患者中常规使用。
结论
目前没有足够的证据推荐常规初始使用大多数特定疾病配方，因为大多数患有相关疾病的患者能够耐受标准肠内配方。然而，临床医生应密切监测不耐受迹象，并在适当的时候使用特定疾病配方。
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