The purpose and principle of nutritional therapy is to increase appetite and improve digestive function through diet therapy; Control the development of the disease; Enhance the body's resistance and promote the repair, regeneration and functional recovery of liver cells. Take the principle of "three highs and one moderation", that is, a diet with high energy, high protein, high vitamins and moderate fat.
Nutritional treatment measures:
(1) Ensure sufficient energy.
According to the condition, the protein supply should be adjusted, the energy supply should be higher than that of normal people, and the protein supply should be 65,438+0.2 ~ 65,438+0.5g per kilogram of body weight per day, which is limited to patients who can tolerate and maintain nitrogen balance and promote hepatocyte regeneration without inducing hepatic encephalopathy, and pay attention to the supply of protein with biological value. High-protein diet is to promote the repair and regeneration of damaged liver cells, which is especially important for those with low plasma protein and edema and ascites. For intractable ascites, due to loss of appetite, necessary diet, enteral nutrition or intravenous nutrition can be used when necessary. In the case of liver failure and coma, the supply of protein should be limited to about 25 ~ 35g, so as to avoid the increase of blood ammonia and aggravate the condition. Animal protein should be temporarily banned in hepatic coma. Protein rich in branched-chain amino acids and low in ammonia production can be selected, such as tofu.
(2) The fat supply should be appropriate.
The supply of fat is generally 40 ~ 50g, and the bile synthesis and secretion of patients with liver disease are reduced, and the digestion and absorption of fat are reduced. Excessive fat intake can be deposited in the liver, further damaging liver function. Too little fat will affect the cooking taste and reduce the appetite of patients. Medium-chain triglyceride is used as edible oil in the diet of patients with liver cirrhosis, and it also has good curative effect on patients.
(3) Protecting liver and detoxifying
Adequate carbohydrates can protect the liver and detoxify, and 300 ~ 450g of carbohydrates can be supplemented every day to avoid hypoglycemia caused by poor liver function. When the intake of staple food is low, some sweets and honey can be added appropriately.
(4) Supplementing rich vitamins and trace elements.
Vitamin C can promote the synthesis of hepatic glycogen, the utilization of folic acid and iron, and improve the level of vitamin C can protect liver cells and promote the regeneration of hepatic glycogen. For those with bleeding tendency and coagulation disorder, vitamin K should be supplemented appropriately. Folic acid and zinc are also beneficial to stem cell regeneration. Eat more foods with high zinc content such as lean pork, beef and mutton, eggs and fish. Patients with liver cirrhosis are prone to magnesium deficiency, so foods with high magnesium content should be supplemented, such as green leafy vegetables, peas, dairy products and cereal compounds.
(5) Limit salt and water
When ascites occurs, it is important to limit salt and water, and strictly limit the intake of sodium and water. Salt-free diet should be given when severe ascites occurs.
(6) Adjust or supplement other electrolytes
When taking potassium diuretics, attention should be paid to supplementing potassium salts. All kinds of vegetables, fruits, dried beans, meat, fish and fungi in food are rich in potassium.
(7) Cooking methods and diet choices
Cooking methods require diversification, paying attention to color, aroma, taste and shape to stimulate patients' appetite; Use as little or no spicy food or seasoning as possible; Avoid all raw, hard, crisp and coarse foods, such as fish with thorns, meat with broken bones and foods containing a lot of crude fiber, such as celery, leeks and soybean sprouts.