重视微量营养素的缺乏与诊治

The treatment and diagnosis of micronutritiens in the surgical patients

危重病人或病程稍长的病人,可能出现微量营养素缺乏。如不能及时补充可影响疾病的诊治与转归。较为常见的是维生素K缺乏引起的凝血机制障碍;维生素B12缺乏引起的巨幼红细胞贫血;磷缺乏引起的再灌食综合征以及维生素B1缺乏引起的运动共济失调、视觉障碍和心理改变。对于危重应激病人,单纯补充葡萄糖、脂肪和氨基酸这三大营养素,会进一步增加维生素B1的需要量,增加Wernicke脑病的发病率。及时补充微量营养素可消除这些微量营养素缺乏的症状。

Micronutritiens deficiency may develop in the critically ill or in the long term hospitalized surgical patients. Vitamin K deficiency could cause coagulopathy and spontaneous bleeding. B12 deficiency is the cause of pernicious anemia. Refeeding syndrome is usually caused by deficiency of phosphorous when malnourished patients start restore nutritonal support. Wernicke encephalopathy is a syndrome characterised by ataxia, ophthalmoplegia, confusion, and impairment of short-term memory. It is often resulting from inadequate intake or absorption of thiamine （vitamin B 1）, especially in conjunction with carbohydrate ingestion.