Zink Thomas M, Kent Suzanne E, Choudhary Arjun N, Kavolus Joseph J
Tufts Medical Center, Boston, Massachusetts.
Tufts University School of Medicine, Boston, Massachusetts.
J Bone Joint Surg Am. 2023 Dec 6;105(23):1897-1906. doi: 10.2106/JBJS.23.00259. Epub 2023 Oct 19.
➤ Malnutrition is common among subsets of patients undergoing orthopaedic surgery and is associated with an increased risk of postoperative complications.➤ Serum proteins, in particular, albumin, may be used in the evaluation of nutritional status.➤ Anthropometric measurements and surveys also play a role in the evaluation of nutritional status.➤ Increased energy and nutrient requirements due to surgical procedures necessitate increased caloric and protein intake in the perioperative period, which may be achieved through diet or supplementation.➤ Evidence supports the use of protein-calorie, amino acid, and immunonutrition supplements. Vitamin D supplementation is an area of further consideration.➤ Diet restriction, activity alterations, pharmacotherapy, and bariatric surgery are all safe, effective approaches to weight loss, although the optimal timing and magnitude of preoperative weight loss require further investigation.
➤ 营养不良在接受骨科手术的部分患者中很常见,且与术后并发症风险增加相关。
➤ 血清蛋白,尤其是白蛋白,可用于评估营养状况。
➤ 人体测量和调查在营养状况评估中也发挥作用。
➤ 手术操作导致的能量和营养需求增加,使得围手术期需要增加热量和蛋白质摄入,这可通过饮食或补充剂来实现。
➤ 有证据支持使用蛋白质热量、氨基酸和免疫营养补充剂。补充维生素D是一个需要进一步考虑的领域。
➤ 饮食限制、活动改变、药物治疗和减重手术都是安全有效的减肥方法,尽管术前减肥的最佳时机和幅度需要进一步研究。