肝癌是常见的消化系统恶性肿瘤，发病率占我国恶性肿瘤的第4位，死亡率占第2位。营养不良贯穿肝癌患者的整个病 程，发生率高达80%，肝癌患者经历肌肉蛋白质消耗和支链氨基酸氧化减少，营养不良以蛋白质⁃能量营养不良多见。肝癌患者在 入院时应进行常规的营养诊断（营养筛查、营养评估及综合评定），并遵循五阶梯治疗原则进行营养干预。稳定期肝癌患者每日能 量供给30～35 kcal/kg，每日蛋白质供给1.2～1.5 g/kg，对于肝性脑病患者，酌情减少蛋白质摄入和合理选择蛋白质来源。存在代谢 紊乱、多器官功能不全的肝癌患者，需行多学科联合治疗，并坚持全程营养管理。因肝癌患者接受肝切除、肝移植及介入治疗后存 在不同的营养问题，同时肝癌患者常并发肝硬化、肝性脑病、肌肉减少症及肌少症性肥胖等，不同疾病状态下个体化营养治疗对于 肝癌患者的生活质量和预后均具有积极作用。因此，本文总结了肝癌患者不同疾病状态时的营养治疗，以期改善肝癌患者的预后。

Liver cancer is one of the most common malignant tumor that occurs in digestive system. Liver cancer is the 4th in morbidity and 2nd in mortality in China, which is a seriously endanger people's health and life. Malnutrition occurs throughout the entire course of liver cancer and the incidence of malnutrition is 80%. Patients often experience muscle protein consumption and decreased oxidation of branched amino acids, especially protei⁃energy malnutrition. For the diagnosis of malnutrition, liver cancer patients need routine nutritional diagnosis (nutrition screening, nutritional assessment and comprehensive assessment) when they are admitted to hospital, and follow the five⁃step principle for nutrition intervention. Optimal daily energy intake should not be lower than 30-35 kcal/kg, optimal daily protein intake should not be lower than 1.2-1.5 g/kg. For patients with hepatic encephalopathy need to reduce protein intake as appropriately and select protein sources reasonably. Patients with liver cancer with metabolic disorders and multiple organ dysfunction require multidisciplinary treatment and adhere to full nutritional management. Liver cancer patients which undergo liver resection, liver transplantation and interventional treatment have various nutritional problems, also accompanied by liver cirrhosis, hepatic encephalopathy, sarcopenia and sarcopenic obesity, individualized nutritional therapy in different disease states have a positive effect on the quality of life and prognosis of liver cancer patients. This article summarizes the nutritional therapy of patients with liver cancer in different clinical disease states to improve the prognosis of patients with liver cancer.