Pennington C R
Department of Gastroenterology, Ninewells Hospital and Medical School, Dundee, Scotland, UK.
Postgrad Med J. 1998 Feb;74(868):65-71. doi: 10.1136/pgmj.74.868.65.
Malnutrition is associated with increased morbidity and mortality and is common in patients admitted to hospital. Nutritional status is not routinely assessed on admission, and nutritional depletion escapes recognition in the majority of affected patients. Nutritional status declines during hospital stay, and this trend is most marked in patients who are already malnourished on admission. Techniques for nutritional support are available, their appropriate use leads to improved nutritional status and clinical outcome in most patients. There is evidence that the current use of artificial nutrition is suboptimal and associated with a high complication rate. The introduction of clinical guidelines and the formation of nutrition support teams will improve nutritional management in the future. The development of new substrates and 'pharmaconutrition' is likely to further improve the outcome for many patients. There will remain a need for more studies to define the cost efficacy of artificial nutrition across a broad spectrum of clinical practice.
营养不良与发病率和死亡率增加相关，且在住院患者中很常见。入院时通常不常规评估营养状况，大多数受影响患者的营养消耗未被识别。住院期间营养状况会下降，这种趋势在入院时就已营养不良的患者中最为明显。有营养支持技术，其合理使用可使大多数患者的营养状况和临床结局得到改善。有证据表明，目前人工营养的使用并不理想，且并发症发生率很高。临床指南的引入和营养支持团队的组建将在未来改善营养管理。新底物和“药物营养”的发展可能会进一步改善许多患者的结局。仍需要更多研究来确定人工营养在广泛临床实践中的成本效益。
