对肠内营养支持的再认识

Understanding and Application of Enteral Nutrition Support

目的对肠内营养支持的发展现状进行总结。方法复习近年来国内外关于肠内营养支持的研究文献,并进行综述。结果存在营养不良和营养风险的患者仍占据住院患者群体的一大部分。在其治疗过程中,肠内营养支持发挥了重要作用,其能够改善患者不良临床结局,如缩短住院时间及减少住院花费。肠内营养途径有口服和管饲,目前喂养管放置技术包括鼻胃置管、鼻空肠置管、术中胃或空肠造口、经皮内镜下胃造口、经皮内镜下胃造口-空肠置管等。在实施肠内营养(尤其是术后开展早期肠内营养支持)过程中,需重视患者的耐受性,如腹胀腹泻、反流和误吸,以利于患者的术后康复。结论专业化和个体化应始终贯彻在临床肠内营养支持的全过程。

Objective To summarize the application of enteral nutrition support in hospitalized patients. Methods The related literatures about enteral nutrition support in recent years were reviewed. Results The rates of malnutrition and nutritional risk were still high in patients. Enteral nutrition support could improve the condition and result of these cases in better clinical outcome, such as shorten hospitalization time and reduced the cost of hospital expenditure. Enteral nutritional support included both oral supplementation and tube-feeding techniques. Artificial nutrition may be provided by nasal tube（nasogastric or nasojejunal tube） or surgically placed tube（gastrostomy, jejunostomy, percutaneous endoscopic gastrostomy or percutaneous endoscopic gastrostomy-jejunostomy）. More attention should be paid to the issues relating to feeding intolerance, including abdominal distension, diarrhea, reflux, and aspiration, especially for postoperative patients with early enteral nutrition support. Conclusion Enteral nutrition support requires highly individually and specialized tailored management.