《欧洲临床营养和代谢学会指南:外科临床营养》解读

Interpretation for ESPEN guideline: clinical nutrition in surgery

欧洲临床营养与代谢学会(ESPEN)于2017年6月发布了外科临床营养指南。该指南从代谢和营养的角度指出手术病人的围手术期处理应包括以下几个关键方面:营养治疗应全程贯穿于手术病人的围手术期管理;避免围手术期的长时间禁食;术后尽早恢复经口进食;如有营养不良风险应尽早开始营养治疗;围手术期良好的代谢调节(如血糖调节);降低手术造成的应激性分解代谢和减轻对胃肠道功能的影响;术后尽量缩短气道管理中麻痹性药物的应用时间;促进蛋白质合成和动员肌肉功能的恢复。

The guideline clinical nutrition in surgery was elaborated by ESPEN （The European Society for Clinical Nutrition and Metabolism） in June 2017. From a metabolic and nutritional point of view, the guideline highlight the key aspects of perioperative care include： integration of nutrition into the overall management of the patient, avoidance of long periods of preoperative fasting, re-establishment of oral feeding as early as possible after surgery, start of nutritional therapy early, as soon as a nutritional risk becomes apparent, favorable metabolic control e.g. of blood glucose, reduction of factors which exacerbate stress-related catabolism or impair gastrointestinal function, minimize time on paralytic agents for ventilator management in the postoperative period, early mobilisation to facilitate protein synthesis and muscle function.