基于加速康复外科理念的重症患者围手术期营养管理

Perioperative nutrition management for critically ill patients based on the concept of enhanced recovery after surgery

基于加速康复外科(ERAS)理念的营养管理在重症患者围手术期领域受到越来越多的重视。ERAS的术前、术后营养干预是围手术期营养的核心内容。对于重症患者,肠内营养评估表单是能够提高肠内营养实施质量的手段。胃管、空肠营养管的管理需根据患者状况进行个性化选择。听诊辅助徒手空肠营养管置入法或更便于ICU患者建立空肠营养通路。文章从术前营养评估与支持、术后营养管理、重症患者肠内营养表单管理、胃管及空肠营养管肠内营养路径、免疫营养制剂等方面探讨ERAS的营养管理。

Nutrition management based on enhanced recovery after surgery(ERAS)programs is a continuously evolving field in perioperative critical illness.Preoperative and post-operative nutritional measurement of ERAS are the core of perioperative nutrition.For critically ill patients,enteral nutrition assessment checklist may be able to improve the quality of enteral nutrition implementation.The management of gastric tube jejunal nutrition tube needs to be personalized according to the patient’s condition.Auscultation-assisted bare-handed jejunal tube placement may make it easier for ICU patients to establish jejunal nutrition pathways.This paper will discuss nutrition management based on ERAS.