低氮低热量肠外营养在胃肠道手术后应激期的应用

Utilization of low-nitrogen low-calorie parenteral nutrition in stress period of gastrointestinal tract major surgery

腹部大手术后一般建议早期采用肠内营养(EN)。在胃肠道手术后急性应激期以及在术后短期因各种情况无法采用EN的病人,传统剂量肠外营养(PN)支持的合理性日益受到质疑。在术后应激期热氮量摄入不足,可能会影响术后恢复。而过多量的热氮负荷亦可导致代谢紊乱,对术后恢复不利。以下就术后应激期低氮低热量PN支持相关基础和临床研究进展进行综述。

The concept of total parenteral nutrition（TPN） has been firmly established.However,whether standard TPN is suitable for the acute stress period after abdominal surgery remains controversial.In postoperative stress period,insufficient nutritional support may be unfavorable to postoperative recovery.On the other hand,excessive calorie and nitrogen loading may lead to metabolic disorders which might be detrimental to the postoperative recovery.This review was to assess the pros and cons of low-nitrogen low-calorie parenteral nutrition in comparison with standard TPN from the aspect of metabolic changes and clinical course of postoperative recovery.