2022版欧洲肠外肠内营养学会家庭肠内营养治疗指南解读  

nterpretation of ESPEN practical guideline:home enteral nutrition in 2022

作　　者：于媛 刘淼 丛明华 Yu Yuan;Liu Miao;Cong Minghua(Department of Thoracic Surgery,National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Bejing 100021,China;Department of Comprehensive Care,National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospial,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心,国家肿瘤临床医学研究中心,中国医学科学院北京协和医学院肿瘤医院胸外科,北京100021 [2]国家癌症中心,国家肿瘤临床医学研究中心,中国医学科学院北京协和医学院肿瘤医院综合科,北京100021

出　　处：《肿瘤代谢与营养电子杂志》2024年第5期602-614,共13页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：中国癌症基金会北京希望马拉松专项基金(LC2022C02);中国医学科学院医学与健康科技创新工程项目(2022-I2M-C&T-B-084)。

摘　　要：营养风险高或营养不良、口服途径无法满足营养需求,且胃肠道功能正常的患者应开展肠内营养治疗,如果患者的营养摄入可能在1周或更长时间内定性或定量不足,可通过专业的营养支持小组的指导在家庭内进行肠内营养治疗。实施家庭肠内营养可有效降低并发症发生率,缩短住院时间,节省医疗成本,改善患者的临床结局,具有显著的临床效益和成本效益。随着医疗的发展,更多的患者愿意在家中接受长期的肠内营养支持。2022年欧洲肠外肠内营养学会(ESPEN)发布了最新版家庭肠内营养指南,该指南以2019年发表的指南为基础,提供了最新的现有证据和专家意见,并且内容多以决策流程图的方式呈现,使其更加直观、精炼。该指南提出了对家庭肠内营养(HEN)的适应证、HEN的设备评估、HEN的推荐产品、HEN的监测和终止、HEN的结构要求5个方面的61条推荐建议,对指导患者进行家庭肠内营养治疗提供非常重要的参考意见。本文对该指南进行解读,重新归类整理推荐意见,旨在增进理解,为HEN实践提供指导。Patients who are at high nutritional risk or are malnourished,whose nutritional needs are not met by oral pathways,and whose gastrointestinal function is normal should be treated with enteral nutrition therapy.If the patient's nutritional intake is likely to be qualitatively or quantitatively inadequate for a week or more,enteral nutrition support therapy may be administered at home under the guidance of a professional nutrition support team.The implementation of home enteral nutrition can effectively reduce the incidence of complications and hospital stay,save medical costs,improve the clinical outcome of patients,and have significant clinical and cost effectiveness.With the development of medical treatment,more patients are willing to receive long-term enteral nutrition support at home.In 2022,the European Society for Clinical Nutrition and Metabolism(ESPEN)published the latest edition of the practical guideline:Home enteral nutrition,which build on the guidelines published in 2019,providing the latest available evidence and expert opinion,and the content is presented in the form of a decision flow chart to make it more intuitive and refined.The guidelines put forward 61 recommendations on 5 aspects:indications for HEN,equipment evaluation for HEN,recommended products for HEN,monitoring and termination of HEN,and structural requirements for HEN,providing very important reference opinions for guiding patients to conduct home enteral nutrition therapy.This article interprets the guidelines,recategorize recommendations,and aims to improve understanding and provide guidance for family enteral nutrition practice.

关 键 词：欧洲肠外肠内营养学会 肠内营养 居家营养 家庭肠内营养 营养护理 并发症 指南 解读 

分 类 号：R459.3[医药卫生—治疗学]