肠系膜缺血性疾病的营养支持治疗

Nutritional support in mesenteric ischemia

肠系膜缺血性疾病常继发肠道功能障碍,如何为这一类病人提供营养支持,成为临床医生必须面对的挑战。肠外营养支持解决了肠道功能障碍继发的营养问题,极大地改善了肠系膜缺血性疾病的预后。但肠道除消化功能外,还有肠屏障功能。肠内营养能够维持肠屏障功能,因而早期肠内营养也逐渐受到重视。然而肠系膜缺血性疾病继发的喂养不耐受,使得早期肠内营养临床应用并不广泛。根据临床实际情况,尽早在肠外营养基础上联合肠内营养,制定个性化的营养支持方案,并且根据病情变化及时调整,应当成为肠系膜缺血性疾病营养支持的基本策略。

Mesenteric ischemia is always accompanied by bowel dysfunction，thus appropriate way for nutritional is important. Parenteral nutrition solves the nutritional problem and greatly improves the prognosis of mesenteric ischemia. Intestine is not only a place for digestion，but also an important barrier. For enteral nutrition can maintain intestinal barrier function，more and more attentions are paid on an earlier start for enteral nutrition. But feeding intolerance which is secondary to the mesenteric ischemia makes early enteral nutrition not widely applied in clinic. A personalized nutrition support plan based on the clinical situation and a combination of parenteral nutrition and enteral nutrition as early as possible should be the basic strategy of nutrition support for mesenteric ischemia