危重症患者的营养治疗策略

Nutritional treatment strategy for critically ill patients

对于危重症患者来说,营养支持治疗是关键的治疗措施之一。肠外营养能较顺利的补充人体所需要的各类营养物质,但易导致肠外营养相关性肝病,原因为脂质不均衡、肠道缺乏肠内营养的刺激和滋养、营养物质失衡。肠内营养不易实施,但更符合人体的生理需求,对维护肠屏障功能十分必要。在肠道能耐受的前提下,适当增加肠内营养量有利于患者恢复。目前认为,渐进式增加蛋白质的补充有利于改善患者的预后。主张采取个体化的营养策略,根据患者的胃肠功能、全身代谢状况及各项营养指标,及时调整营养方案。

Nutrition support treatment is one of the key treatments for critically ill patients.Parenteral nutrition can smoothly supplement various nutrients needed by the human body.But it is easy to cause parenteral nutrition-related liver disease.The reasons are:1.lipid imbalance;2.lack of enteral nutrition stimulation and nourishment in the intestine;3.Nutrient imbalance.Enteral nutrition is not easy to implement.But it is more in line with the physiological needs of the human body and is necessary for maintaining the intestinal barrier function.Under the premise of tolerance to the intestine,an appropriate increase in enteral nutrition is conducive to recovery.It is currently believed that progressively increasing protein supplementation is beneficial to improve patient outcomes.These measures are advocated that adopting individualized nutrition strategy,and timely adjusts nutrition plan according to patients'gastrointestinal function,systemic metabolic status and various nutritional indicators.