胆道肿瘤患者的营养治疗共识.pdfVIP

胆道肿瘤患者的营养治疗共识

中国抗癌协会肿瘤营养专业委员会，中华医学会肠外肠内营养学分会

摘要：胆道系统恶性肿瘤在世界范围内虽然不算常见，但其发病率逐年上升，且恶性程度较高。我国胆道系统恶性肿瘤

的发病率也有逐年上升的趋势。胆管癌患者的预后均很差，因此，胆道系统恶性肿瘤的姑息和支持治疗尤为重要，其主要目的

是尽可能地提高生活质量、延长生存时间。肝门部胆管癌患者术后早期进食能够有效减少感染、腹胀和尿潴留等并发症的发

生，加快患者术后康复。胆道恶性肿瘤营养治疗途径的选择原则与其他恶性肿瘤基本一致，但也有其特点:①胆道手术多限于

上消化道，空肠以下肠管受影响较小。②对于术前存在营养不良，特别是合并中度以上梗阻性黄疸的患者，建议经口或经鼻空

肠置管或者经T形管空肠置管途径肠内营养。③对于肝功能储备较差、行较大范围肝切除或严重梗阻性黄疸的患者，应积极

行胆道内支架引流或行经皮肝穿刺胆道引流术进行胆道减压，尽快改善肝功能，促进营养物质代谢吸收。④经皮肝穿刺胆道

引流（PTCD）是临床广泛应用的治疗恶性胆道梗阻的方法。

关键词：胆道肿瘤；营养不良；营养治疗

Expertopiniononnutritionaltreatmentforpatientswithbiliarytracttumors

ChineseSocietyofNutritionalOncology；ChineseSocietyforParenteralandEnteralNutrition

Abstract:AlthoughbiliarytractChineseSocietyofNutritionalOncologymalignancyisnotcommonintheworld,its

incidenceisincreasingyearbyyearanditsmalignancyishigh.TheincidenceofbiliarytractmalignancyinChinaisalso

increasingyearbyyear.Theprognosisofpatientswithcholangiocarcinomaispoor.Therefore,thepalliativeandsupportive

treatmentsofmalignanttumorsofthebiliarytractsystemareparticularlyimportant,withthemainpurposeofimprovingthe

qualityoflifeandextendingthesurvivaltimeasmuchaspossible.Themalignanttumorpalliativebiliarysystemandnutrition

treatmentisparticularlyimportant.Itsmainpurposeistoimprovethequalityoflifeasmuchaspossible,toprolongsurvival

time.Earlypostoperativefeedinginpatientswithhilarcholangiocarcinomacaneffectivelyreducetheincidenceofcomplications

suchasabdominaldistentionandurinaryretention,andacceleratepostoperativerehabilitationofpatients.Theprincipleof

selectionofnutritionaltreatmentapproachesforbiliarytractmalignanttumorsisbasicallythesameasthatforothermalignant

tumors,butitalsohasitscharacteristics:1.biliarytractsurgeryismostlylimitedtotheupperdigestivetract,andtheintestinal

canalbelowthejejunumislessaffected.2.Forpatientswithpreoperativemalnutrition,especiallythosewithmoderateorabove

obstructivejaundice,enteralnutritionthrough