慢性肝病患者肠外肠内营养支持与膳食干预专家共识

肝脏是人体最重要的代谢器官，肝脏发生疾病时可出现复杂的营养素代谢改变和不同程度的营养不良（不足），而营养状态又反过来影响肝病的发生、发展和预后，形成恶性循环。营养支持（肠外营养支持、肠内营养支持、膳食干预）在慢性肝病患者（代偿期/失代偿期肝硬化、慢加急/亚急性肝衰竭、慢性肝衰竭）的治疗中起重要作用。但此领域缺少大样本、高质量的临床研究报告，且国内尚无有关临床诊疗的“共识”。从合理应用营养支持疗法，改善慢性肝病患者临床结局出发，本“共识”专家组系统总结相关文献，并结合我国慢性肝病的临床实践，完成此共识，以期为慢性肝病诊疗有关的医师、护士（师）、营养师、药剂师们提供临床参考。

Consensus on the clinical nutritional intervention for patients with chronic liver diseases

Liver is the most important metabolic organ in human body. Chronic liver diseases can be accompanied by changes in nutrient metabolism and malnutrition (undernutrition), whereas poor nutrition in return can worsen the development and prognosis of liver diseases, forming a vicious cycle. Nutritional support including parenteral and enteral nutrition and dietary interventions plays a key role in the treatment of patients with chronic liver disease (compensated or decompensated cirrhosis, acute or chronic liver failure, and chronic liver failure). However, few evidences have been obtained from large-scale high-quality clinical trials. With an attempt to optimize nutritional support therapy and improve the outcomes of patients with chronic liver diseases, we established this concensus document to facilitate the clinical decision-making by physicians, nurses, dietitians, and pharmacists in clinical settings.