Herreros J, De Oca J, Sanchez R, Casares J, Llorens R, Arcas R, Lorente M, Sanz M L
J Chir (Paris). 1985 Dec;122(12):707-10.
A series of 60 consecutive patients treated by heart valve replacement surgery under extracorporeal circulation were reviewed. Poor nutrition was assessed in 28% of these cases, the cardiac index in these patients being significantly smaller than in operated patients with normal nutritional states (2.07 +/- 0.8 as against 2.46 +/- 0.7, p less than 0.01). Furthermore, 58% of those with poor nutrition presented postoperative complications: mediastinitis, wound infection, ventricular arrhythmias or secondary pulmonary infection. One death occurred in this group. Postoperative complications in patients with normal nutritional states developed in only 6% and there were no deaths. Duration of hospital stay was significantly longer in patients with poor nutrition (p less than 0.05). Apart from immunoglobulin levels, all immunologic parameters underwent postoperative modifications related to nutritional state. Physiopathologic hypotheses are proposed as well as a programme for increasing nutritional intake in patients in a precarious metabolic state which predisposes them to complications.
回顾了一系列60例在体外循环下接受心脏瓣膜置换手术的连续患者。其中28%的病例存在营养不良，这些患者的心脏指数显著低于营养状态正常的手术患者（分别为2.07±0.8和2.46±0.7，p<0.01）。此外，58%的营养不良患者出现了术后并发症：纵隔炎、伤口感染、室性心律失常或继发性肺部感染。该组中有1例死亡。营养状态正常的患者术后并发症发生率仅为6%，且无死亡病例。营养不良患者的住院时间显著更长（p<0.05）。除免疫球蛋白水平外，所有免疫参数术后均发生了与营养状态相关的改变。提出了病理生理假说以及针对处于不稳定代谢状态、易发生并发症患者增加营养摄入的方案。
