心脏外科术后患者营养支持治疗研究进展

Nutritional support for patients after cardiac surgery:Research progress

心脏外科术后患者常因能量摄入不足而出现营养障碍,从而导致并发症发生率及病死率增高。注重热量及蛋白质的补充有利于患者病情恢复,而肠内营养被认为是心脏外科术后的主要营养支持方式。越来越多的研究表明,采用肠内营养合并肠外营养的方式可为患者提供更好的营养支持,虽然肠外营养的使用时机仍有争议,但目前普遍认为术后早期使用肠内营养对患者有益。该文就营养支持对心脏外科术后患者的重要性,心脏外科术后营养支持方式的选择、时机、使用时程,以及营养风险评估等方面的进展进行综述。

The patients after cardiac surgery often suffer from malnutrition due to insufficient energy intake,which increases the incidence of complications and mortality.Thus,energy and protein intake can accelerate patients’recovery.Previously,enteral nutrition has been widely considered to be the major nutritional way,however,an increasing studies suggest a combination of enteral and parenteral way can provide nutrition to patients maximally.Albeit the timing of the inception of parenteral way of nutrition remains controversial,it is confirmed that early start of the enteral way is salubrious to patients,and the duration of nutritional support should be determined according to the specific situation of patients.Additionally,nutritional scoring system plays a crucial role.Various nutritional risk scores can predict the clinical outcome of patients,thus,the most adaptable nutritional score for patients after receiving cardiac surgery needs further study.This article reviews the importance of nutritional support for the patients after cardiac surgery,selection,timing,and duration of post-operative nutritional support,and the advances in nutritional risk assessment etc.