Silva Marco, Gomes Sara, Peixoto Armando, Torres-Ramalho Paulo, Cardoso Hélder, Azevedo Rosa, Cunha Carla, Macedo Guilherme
Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal.
General Practice Department, Unidade Saúde Familiar Alfena, Porto, Portugal.
GE Port J Gastroenterol. 2015 Aug 31;22(6):268-276. doi: 10.1016/j.jpge.2015.06.004. eCollection 2015 Nov-Dec.
Protein-calorie malnutrition is a transversal condition to all stages of chronic liver disease. Early recognition of micro or macronutrient deficiencies is essential, because the use of nutritional supplements reduces the risk of complications. The diet of patients with chronic liver disease is based on a standard diet with supplements addition as necessary. Restrictions may be harmful and should be individualized. Treatment management should aim to maintain an adequate protein and caloric intake and to correct nutrient deficiencies. The large majority of patients with grade I/II hepatic encephalopathy can tolerate a regular diet. Protein restriction can aggravate malnutrition and is not recommended, except in cases of hepatic encephalopathy unresponsive to optimized therapy.
蛋白质 - 热量营养不良是慢性肝病所有阶段的一种普遍状况。早期识别微量或宏量营养素缺乏至关重要，因为使用营养补充剂可降低并发症风险。慢性肝病患者的饮食基于标准饮食，并根据需要添加补充剂。限制可能有害，应因人而异。治疗管理应旨在维持足够的蛋白质和热量摄入，并纠正营养素缺乏。绝大多数I/II级肝性脑病患者能够耐受常规饮食。除了对优化治疗无反应的肝性脑病病例外，蛋白质限制会加重营养不良，不建议采用。
