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作 者:刘淼 于媛 丛明华 Liu Miao;Yu Yuan;Cong Minghua(Department of Thoracic Surgery,National Cancer Center/NationalClinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;Department of Comprehensive Care,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,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》2025年第1期7-16,共10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:慢性病共病是指个体同时患有两种及两种以上的慢性疾病,其对患者的生理和心理都造成巨大的负担。目前,随着全球人口老龄化程度的日益加深和各种慢性疾病患病率的增加,慢性病共病发生率逐年上升,已成为严重的全球性公共卫生问题。共病住院患者易发生疾病相关营养不良,营养治疗可以减少共病患者的发病率和其他并发症的发生,降低对疾病预后的影响。2024年欧洲肠外肠内营养学会(ESPEN)发布了最新版ESPEN共病住院患者营养支持指南(以下简称指南),该指南以2018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。该指南提出了对共病住院患者进行营养筛查、个性化营养治疗、营养需求量的估算、早期营养治疗、出院后的营养治疗及监测、营养治疗的组织管理改革等方面的32条推荐建议,对共病住院患者进行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,以助力医护人员更好地理解与应用,推动指南的有效施行。Chronic polymorbidity refers to the situation where an individual suffers from two or more chronic diseases,which has a huge burden on the patient's physical and psychological health.Currently,with the increasing aging of the global population and the rising prevalence of chronic diseases,the incidence of chronic polymorbidity is rising year by year,becoming a serious global public health problem.Patients with polymorbidity are prone to disease-related malnutrition,and nutritional support can reduce the incidence of polymorbidity and other complications,and reduce the impact on disease prognosis.In 2024,the European Society for Clinical Nutrition and Metabolism published the latest edition of the ESPEN practical guideline:Nutritional support for polymorbid medical inpatients.Based on the 2018 guideline,this guideline provides the latest available evidence and expert opinion,and the content is presented in the form of decision flowcharts,making it more intuitive and concise.The guideline proposes 32 recommendations for nutritional screening,individualized nutritional support,nutrient requirement estimation,early nutritional support,post-discharge nutritional support and monitoring,and nutritional support organizational management reform,providing very important reference opinions for nutritional support for patients with polymorbidity.This article interprets the guidelines and reclassifies the recommendations,aiming to enhance understanding,help medical professionals better understand and apply,and promote the effective implementation of the guidelines.
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