手术期、恶液质期的恶性肿瘤（恶病质状态）患者由于肿瘤的消耗、阻碍进食和消化、以及肿瘤对食欲的影响、患者精神抑郁等因素，伴随的以体重下降为特征的营养不良比较常见，因此应尽早对患者进行营养补充。

　　特殊医学用途肿瘤全营养配方产品应适当提高蛋白质的含量并调整与机体免疫功能相关的营养素含量，为患者提供每日所需的营养物质。

　　恶性肿瘤（恶病质状态）病人用全营养配方食品应满足如下技术要求：

　　1)蛋白质的含量应不低于 0.8 g/100kJ (3.3 g/100kcal)。

　　2)n-3脂肪酸（以EPA和DHA计）在配方中的供能比应为1%-6%,同时对亚油酸和α-亚麻酸的供能比不再做相应要求。

　　3)可选择添加营养素（精氨酸、谷氨酰胺、亮氨酸）。如果添加精氨酸，其在产品中的含量应不低于0.12g/100 kJ (0.5g/100kcal)；如果添加谷氨酰胺，其在产品中的含量应为0.04g/100kJ -0.53g/100kJ（0.15g/100kcal- 2.22g/100kcal）；如果添加亮氨酸，其含量应不低于0.03g/100kJ(0.13g/100kcal)。

　　参考依据：

　　[1] J. Arends,G. Bodoky, et al. ESPEN Guidelines on Enteral Nutrition : Non-surgical oncology. Clinical Nutrition, 2006, 25, 245-259.

　　[2] 顾景范, 杜寿玢, 郭长江主编. 现代临床营养学. 北京：科学出版社。2009, P683.

　　[3] 吴肇汉主编. 实用临床营养治疗学. 上海: 上海科学技术出版社. 2001: 312-331.

　　[4] A. Weimann, M. Braga, et al. ESPEN Guidelines on Enteral Nutrition: Surgery including Organ Transplantation. Clinical Nutrition, 2006, 25, 224-244.

　　[5] David Allen August, Maureen B. Huhmann, et al. ASPEN. Clinical Guidelines: Nutrition Support Therapy During Adult Anticancer Treatment and in Hematopoietic Cell Transplantation. J Parenter Enteral Nutr, 2009, 33: 472.

　　[6] Ramon Colomer, et al. n-3 Fatty Acids, Cancer and Cachexia: a Systematic Review of the Literature. British Journal of Nutrition 2007, 97: 823-831.

　　[7] Barbara S van der Meij, et al. n-3 PUFAs in Cancer, Surgery, and Critical Case: a Systematic Review on Clinical Effects, Incorporation, and Washout of Oral or Enteral Compared with Parenteral Supplementation.  The American Journal of Clinical Nutrition, 2011, 94: 1248-65.

　　[8] S.RISO, P.ALUFFI, et al. Postoperative Enteral Immunonutrition in Head and Neck Cancer Patients. Clinical Nutrition, 2000, 19 (6): 407-412.

　　[9] Park KG1, Heys SD, Blessing K,et al. Stimulation of Human Breast Cancers by Dietary L-arginine. Clin Sci (Lond), 1992, 82 (4):413-417.

　　[10] 胡细玲, 凌聪, 周雪玲. 谷氨酰胺强化肠内营养在腹腔镜胃癌根治术后早期的应用. 全科护理, 2012, 10(7): 1881-1882.

　　[11] Jiun-jie Lin, Xiu-Juan Chung, et al. A Meta-analysis of Trials Using the Intention to Treat Principle for Glutamine Supplementation in Critically Ill Patients with Burn. Burns, 2013,39:565-570.

　　[12] Joint FAO/WHO/UNU Expert Consultation. Protein and Amino Acid Requirements in Human Nutrition: Report of a Joint WHO/FAO/UNU Expert Consultation. WHO Technical report series; no. 935. WHO Press, 2002: 138-139