关于重症患者个性化医学营养治疗方案的研究进展

Research Progress on Personalized Medicine Nutrition Therapy for Critically Ill Patients

重症监护室(ICU)的医学营养治疗(MNT)旨在预防营养状况良好患者发生营养不良,并阻止或改善营养不良患者的进展。营养不良是重症患者重要的预后危险因素,严重影响患者的预后如住院时间、死亡率、感染率和机械通气时间等。虽然营养状况对重症患者的预后有影响,但最佳营养策略一直是一个令人关注的话题。由于重症患者病情的多样性,为ICU患者个性化定制和调整MNT方案至关重要。因此,本文针对不同类型ICU患者群体给予特定营养治疗的基本原则和方案进行总结与概述,为ICU临床营养治疗提供一定参考。本文主要内容包括:ICU患者营养不良的诊断,营养、能量和蛋白质需求的最佳时间和给予支持途径,特定营养素的补充,以及MNT的监测和并发症。

Medical nutrition therapy(MNT)in the intensive care unit(ICU)aims to prevent malnutrition in well-nourished patients,and stops or improves the progression of malnourished patients.Malnutrition is an important prognostic risk factor for critically ill patients,which seriously affects the prognosis of patients,such as length of hospital stay,mortality rate,infection rate and duration of mechanical ventilation.Although nutritional status has an impact on the prognosis of critically ill patients,the optimal nutritional strategy has always been a topic of concern.Due to the diversity of critically ill patients,it is critical to tailor and adjust timely the MNT scheme for ICU patients.Therefore,this review summarizes and outlines the basic principles and programs of specific nutritional therapy for different types of ICU patients,in order to provide some reference for clinical nutritional therapy in ICU.The main contents of this review include:the diagnosis of malnutrition in ICU patients,optimal time and ways to provide support for nutrient,energy and protein needs,supplementation of specific nutrients,and the monitoring and complications of MNT.