全面的营养指南和儿童肠病的管理策略
Melanie L Savoca1, Jefferson N Brownell2
1Children's Hospital of Philadelphia, Department of Clinical Nutrition, Jill and Mark Fishman Center for Lymphatic Disorders, Comprehensive Vascular Anomalies Program, Philadelphia, PA.
Seminars in pediatric surgery
|June 7, 2024
概括
针对儿科蛋白损失肠病 (PLE) 的医学营养治疗包括限制长链甘油三. 中链甘油三 (MCT) 提供补充卡路里,绕过淋巴细胞以减少蛋白质损失.
科学领域:
- 胃肠道学和营养学
- 儿科医学 儿科医学
- 临床营养学 临床营养学
背景情况:
- 失去蛋白质的肠道病变 (PLE) 是一种综合征,其特点是过度的蛋白质损失进入胃肠道.
- 常见的病因有所不同,但在儿童中,它通常与肠道淋巴管切除症有关.
- 目前与淋巴管切开症相关的PLE的治疗重点是减少肠道胆产量.
研究的目的:
- 介绍儿童蛋白质丧失肠病的推营养干预措施.
- 在这个人群中概述饮食教育和患者咨询的原则.
- 为儿科PLE患者定义关键监测参数.
主要方法:
- 医学营养疗法限制肠道长链甘油三酸 (LCTs) 来降低胆产量.
- 在活性PLE或脂肪限制饮食中,使用中链甘油三酸 (MCT) 来补充卡路里.
- 在患有活性PLE或脂肪限制的患者中监测微量营养素缺乏症.
主要成果:
- 限制LCTs减少了肠道胆的产生,从而减少了淋巴源的肠道蛋白质损失.
- MCT 直接被吸收到血液中,绕过肠道淋巴管,并没有对基生成作出贡献.
- 限制饮食脂肪需要对相关微量营养素缺乏进行监测,特别是在婴儿和幼儿中.
结论:
- 营养治疗是治疗儿科PLE不可或缺的组成部分,特别是当与淋巴管切除症相关时.
- 战略性使用LCT限制和MCT补充可以有效地管理蛋白质损失.
- 综合性监测和患者教育对于优化儿科PLE的结果至关重要.
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