Department of Medicine, Drexel University College of Medicine, Philadelphia, PA 19129, USA.
Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA 94305, USA.
Nutrients. 2017 Oct 13;9(10):1114. doi: 10.3390/nu9101114.
The aim of this work is to develop a pragmatic approach in the assessment and management strategies of patients with cirrhosis in order to optimize the outcomes in this patient population.
A systematic review of literature was conducted through 8 July 2017 on the PubMed Database looking for key terms, such as malnutrition, nutrition, assessment, treatment, and cirrhosis. Articles and studies looking at associations between nutrition and cirrhosis were reviewed.
An assessment of malnutrition should be conducted in two stages: the first, to identify patients at risk for malnutrition based on the severity of liver disease, and the second, to perform a complete multidisciplinary nutritional evaluation of these patients. Optimal management of malnutrition should focus on meeting recommended daily goals for caloric intake and inclusion of various nutrients in the diet. The nutritional goals should be pursued by encouraging and increasing oral intake or using other measures, such as oral supplementation, enteral nutrition, or parenteral nutrition.
Although these strategies to improve nutritional support have been well established, current literature on the topic is limited in scope. Further research should be implemented to test if this enhanced approach is effective.
本研究旨在为肝硬化患者的评估和管理策略制定一种实用方法，以优化该患者人群的结局。
通过对 PubMed 数据库进行检索，于 2017 年 7 月 8 日以前检索到诸如营养不良、营养、评估、治疗和肝硬化等关键词，查找与营养和肝硬化之间的关联相关的文章和研究。
营养不良的评估应分两步进行：第一步，根据肝病的严重程度，确定有营养不良风险的患者；第二步，对这些患者进行全面的多学科营养评估。最佳的营养不良管理应侧重于满足热量摄入的每日推荐量目标，并在饮食中包含各种营养素。应通过鼓励和增加口服摄入或使用其他措施（如口服补充剂、肠内营养或肠外营养）来实现营养目标。
尽管这些改善营养支持的策略已得到充分确立，但该主题的现有文献范围有限。应实施进一步的研究以检验这种强化方法是否有效。
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