Department of Surgery, School of Medical Sciences, Orebro University Hospital and Orebro University, Orebro, Sweden; email:
Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
Annu Rev Nutr. 2024 Aug;44(1):231-255. doi: 10.1146/annurev-nutr-062222-021228.
Over the last decades, surgical complication rates have fallen drastically. With the introduction of new surgical techniques coupled with specific evidence-based perioperative care protocols, patients today run half the risk of complications compared with traditional care. Many patients who in previous years needed weeks of hospital care now recover and can leave in days. These remarkable improvements are achieved by using nutritional stress-reducing care elements for the surgical patient that reduce metabolic stress and allow for the return of gut function. This new approach to nutritional care and how it is delivered as an integral part of enhancing recovery after surgery are outlined in this review. We also summarize the new and increased understanding of the effects of the routes of delivering nutrition and the role of the gut, as well as the current recommendations for artificial nutritional support.
在过去的几十年中，外科手术并发症的发生率已经大幅下降。随着新技术的出现，加上特定的基于证据的围手术期护理方案，与传统护理相比，现在患者发生并发症的风险降低了一半。许多在过去需要数周住院治疗的患者现在可以在几天内康复出院。这些显著的改善是通过使用外科患者的营养应激减轻护理元素来实现的，这些元素可以减轻代谢应激并使肠道功能恢复。本综述概述了这种新的营养护理方法以及如何将其作为增强手术后恢复的一个组成部分来实施。我们还总结了对营养输送途径的作用以及肠道的作用的新的和更多的理解，以及对人工营养支持的当前建议。
