外科危重症患者胃肠功能障碍营养治疗的难点与对策  

Medical nutrition therapy in surgical critical ill patients with gastrointestinal dysfunction:challenges and strategies

作　　者：李幼生[1] Li Yousheng(Department of General Surgery,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院普通外科,上海200011

出　　处：《中华胃肠外科杂志》2024年第3期221-224,共4页Chinese Journal of Gastrointestinal Surgery

摘　　要：胃肠功能障碍(GID)在危重症患者中极其常见且预后不良,医学营养治疗是危重症患者重要的治疗策略之一,能显著改善危重症患者的预后。基于既往研究的证据,已经发布了多个有关危重症患者营养治疗的国际指南或共识,但最新的研究证据对已有的推荐提出了挑战。本文总结危重症患者营养治疗的已有研究结果,从外科危重症患者营养治疗前的评估、早期肠内营养治疗和滋养性喂养目标量与达标时间方面的进展和争议等方面进行讨论,以期为读者提供营养治疗的临床实践建议及未来的研究方向参考。Gastrointestinal dysfunction(GID)is frequently seen in critically ill patients and is associated with worse clinical outcomes.Medical nutrition therapy(MNT)is an integral part of critical care,which may be associated with improved clinical outcomes.The international practical guidelines or consensus for critically ill patients were recommended based on the results of previous investigations.However,the rationale of these recommendations was controversial by the findings of the most recent studies.This review discusses the current developments and controversy about nutritional assessment of critically ill patients prior to medical nutrition therapy,early enteral nutrition,target of trophic feeding,and time to target achievement.This review summarizes the available evidence of MNT in critically ill patients and offers suggestions for clinical practice and future research.

关 键 词：危重症 外科 胃肠功能障碍 医学营养治疗 早期肠内营养 

分 类 号：R459.3[医药卫生—治疗学]