肠内营养临床不良反应分类及预防措施研究进展  

Research progress on classification and prevention of clinical adverse reactions of enteral nutrition

作　　者：刘婧 游倩 饶志勇[1] Liu Jing;You Qian;Rao Zhiyong(West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China)

机构地区：[1]四川大学华西医院临床营养科,成都610041

出　　处：《肿瘤代谢与营养电子杂志》2021年第4期362-365,共4页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：国家重点研发计划项目(2016YFD0400604)。

摘　　要：随着肠内营养在临床上的广泛应用,肠内营养不良反应的发生率也逐渐增高。为提升相关临床人员对肠内营养不良反应的认识,提高营养治疗质量,减少因使用不当造成的肠内营养不良反应,保障患者使用肠内营养的有效性和安全性,为相关医务人员肠内营养规范化管理提供科学依据。提取目前影响肠内营养不良反应,对临床结局影响较大的相关因素,作为监测肠内营养临床不良反应的指标。将肠内营养不良反应分类及预防措施总结如下,肠内营养不良反应类型可分为感官不良反应、胃肠道不良反应、过敏反应、代谢并发症四种类型。可通过口感不适、恶心、呕吐、腹胀、腹泻、胃潴留、过敏情况、高渗脱水、血糖异常、电解质异常、微量元素异常等指标监测是否发生肠内营养不良反应。如发生因肠内营养导致的不良反应需通过调整营养治疗方式,调整喂养温度,调整喂养方式,使用加热器;调整肠内营养制剂类型,使用预消化或短肽型制剂;调整肠内营养用量及浓度,从少到多,从稀到稠,降低渗透压,逐步增加喂养剂量来缓解患者肠内营养不耐受的症状,提高患者的营养水平,预防肠内营养不良反应的发生。With the wide application of enteral nutrition in clinic,the incidence of adverse reactions of enteral nutrition is gradually increasing.In order to improve the understanding of the related clinical personnel on the adverse reactions of enteral nutrition,improve the quality of nutrition treatment,reduce the adverse reactions caused by improper use,and ensure the effectiveness and safety of patients using enteral nutrition,objective to provide scientific basis for the standardized management of enteral nutrition for relevant medical staff.The related factors influencing the clinical outcome of enteral nutrition were extracted as the indicators of monitoring the clinical adverse reactions of enteral nutrition.The classification and preventive measures of enteral nutrition adverse reactions are summarized as follows.The types of enteral nutrition adverse reactions can be divided into sensory adverse reactions,gastrointestinal adverse reactions,allergic reactions and metabolic complications.Gastrointestinal malnutrition can be monitored through monitoring indicators such as taste discomfort,nausea,vomiting,abdominal distension,diarrhea,gastric retention,allergy,hyperosmolar dehydration,abnormal blood glucose,electrolyte abnormalities,and trace elements.In case of adverse reactions caused by enteral nutrition,we need to adjust the way of nutritional support treatment,adjust the feeding temperature,change the bolus to gravity drip or pump,and use the heater;Adjust the way of feeding and use pre digestion or short peptide preparation;adjust the dosage and concentration of enteral nutrition,from less to more,from thin to thick,reduce osmotic pressure,and gradually increase the feeding dose to relieve the symptoms of enteral nutrition intolerance,improve the nutritional level of patients,and prevent the occurrence of enteral nutrition adverse reactions.

关 键 词：肠内营养 不良反应 预防措施 

分 类 号：R459.3[医药卫生—治疗学]