肝移植候选人的营养管理
Saurabh Mishra1, Madhumita Premkumar2
1Department of Gastroenterology and Hepatology, Paras Health, Sector-22, Panchkula, Haryana, 134109, India.
Journal of clinical and experimental hepatology
|September 11, 2023
概括
营养不良影响了大多数肝硬化患者,影响了肝移植 (LT) 的结果. 营养评估,饮食支持和运动对于优化LT候选人和改善其预后至关重要.
科学领域:
- 肝病学和移植医学 肝病学和移植医学
- 营养科学 营养科学
- 老年病学和老年学.
背景情况:
- 营养不良在近三分之二的肝硬化患者中是普遍存在的,这是由于摄入不良,加速饥饿,代谢和合成体抗性.
- 营养状况显著影响肝移植 (LT) 候选人的管理和结果.
- 标志着肌肉质量和功能的减少的萨尔科佩尼亚是一个关键问题,通常与移植后的脆弱和糟糕的结果有关.
研究的目的:
- 突出肝移植候选人的营养评估和优化的重要性.
- 定义sarcopenia,并讨论其对患者结果的影响.
- 在这个人群中概述基于证据的营养和运动干预策略.
主要方法:
- 营养评估包括骨肌肉指数 (CT扫描),手握力和步行速度.
- 饮食建议强调足够的卡路里 (35-40 kcal/kg/day) 和蛋白质 (1.2-1.5 gm/kg/day) 的摄入量.
- 在风险评估后,包括有氧和抵抗训练 (150分钟/周) 在内的运动处方.
- 早期肠道营养 (LT后12-24小时).
主要成果:
- 麻症,麻性肥胖症和骨髓炎与LT候选人的不良结果有关.
- 适当的卡路里和蛋白质摄入量,微量营养素补充和定期炼至关重要.
- 建议在LT后早期进行肠道营养.
结论:
- 包括饮食和运动在内的综合营养管理对于优化肝移植候选人至关重要.
- 多学科的团队方法对于改善这个脆弱的患者群体的结果至关重要.
- 需要进一步研究免疫营养,单体配方和激素替代.
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