Brodanová M
I. internĺ klinika 1. LF UK a VFN, Praha.
Cas Lek Cesk. 1996 Sep 11;135(17):563-6.
The liver is the metabolic centre of all nutrients. Liver disease can thus interfere with the metabolism of the whole organism, it can have a negative impact on the nutritional status and frequently lead to marked malnutrition. On the other hand, attempts to influence liver disease by dietetic provisions have an old tradition while actual evidence of a marked benefit of these prescriptions is lacking. Therefore we witness at present rather regression from strict dietetic provisions, and individual diets are favoured where frequently the main criterium is the tolerance of the recommended diet and suitable technology. The author submits a brief review of the main metabolic changes in the course of liver diseases which contributes to the understanding of reasons for the recommended dietetic provisions. Attention is drawn to pitfalls which may depretiate therapeutic efforts. The author differentiates the procedure in acute and chronic liver diseases. In cirrhosis special restrictions during decompensation are stressed, as then quite different dietetic provisions are needed. Details are given for encephalopathy and conditions of fluid retention with ascites.
肝脏是所有营养物质的代谢中心。因此，肝脏疾病会干扰整个机体的代谢，对营养状况产生负面影响，并常常导致明显的营养不良。另一方面，通过饮食措施来影响肝脏疾病有着悠久的传统，但这些处方显著益处的实际证据却很缺乏。因此，目前我们看到的是从严格的饮食规定上的倒退，个体饮食更受青睐，在个体饮食中，通常主要标准是对推荐饮食和合适技术的耐受性。作者简要回顾了肝脏疾病过程中的主要代谢变化，这有助于理解推荐饮食规定的原因。文中提请注意可能会削弱治疗效果的陷阱。作者区分了急性和慢性肝脏疾病的处理方法。在肝硬化失代偿期强调了特殊限制，因为此时需要截然不同的饮食规定。文中给出了肝性脑病和伴有腹水的液体潴留情况的详细信息。
