[1]王田乔.肠内营养在重症患者中的应用时机研究[J].医学信息,2018,31(01):42-45.[doi:10.3969/j.issn.1006-1959.2018.01.016]
　WANG Tian-qiao.Study on the Timing of Enteral Nutrition in Critically Ill Patients[J].Journal of Medical Information,2018,31(01):42-45.[doi:10.3969/j.issn.1006-1959.2018.01.016]
点击复制

肠内营养在重症患者中的应用时机研究()

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
31卷
期数:
2018年01期
页码:
42-45
栏目:
综述
出版日期:
2018-01-01

文章信息/Info

Title:
Study on the Timing of Enteral Nutrition in Critically Ill Patients
文章编号:
1006-1959（2018）01-0042-04
作者:
王田乔
浙江大学医学院附属第四医院急诊科，浙江义乌322000
Author(s):
WANG Tian-qiao
Department of Emergency,Fourth Affiliated Hospital of Zhejiang University School of Medicine,Yiwu 32000,Zhejiang,China
关键词:
肠内营养; 肠外营养; 危重患者; 延迟喂养
Keywords:
Key words：Enteral nutrition; Parenteral nutrition; Critically ill patients; Delayed feeding
分类号:
R459.3
DOI:
10.3969/j.issn.1006-1959.2018.01.016
文献标志码:
A
摘要:
肠内营养支持符合生理，具有预防黏膜萎缩，维持肠道结构完整性等优点，是重症患者营养支持的首选途径遥但对于不 能控制的休克尧严重烧伤尧上消化道出血尧消化功能障碍等患者，早期肠内营养支持的优势及并发症存在争议遥本文就此问题总 结了肠内营养的应用时机，从而为此类患者肠内营养的实施提供理论支持遥
Abstract:
Abstract：Enteral nutrition support in line with physiology,with the prevention of mucosal atrophy,to maintain the integrity of intestinal structure, etc.,is the preferred way of nutritional support for critically ill patients.However,for uncontrollable shock,severe burns,upper gastrointestinal bleeding, digestive disorders and other patients,the advantages and complications of early enteral nutrition support are controversial.This article summarizes the timing of the application of enteral nutrition,so as to provide theoretical support for the implementation of such patients EN.

参考文献/References:

[1]Kim H,Stotts N A,Froelicher E S,et al.Adequacy of early en- teral nutrition in adult patients in the intensive care unit[J].Jour- nal of Clinical Nursing,2012,21(19pt20):2860-2869.
[2]Elke G,Zanten A R H V,Lemieux M,et al.Enteral versus par- enteral nutrition in critically ill patients:an updated systematic re- view and meta-analysis of randomized controlled trials[J].Critical Care,2016,20(1):1-14.
[3]楼浩明,曹同瓦,杨涵铭.早期肠内营养对危重患者的影响 [J].中国急救医学,2006,26(11):825-826.
[4]Debaveye Y,Van d B G.Risks and benefits of nutritional sup- port during critical illness [J].Annual Review of Nutrition, 2006,26(1):513.
[5]Mancl EE,Muzevich KM.Tolerability and safety of enteral nu- trition in critically ill patients receiving intravenous vasopressor therapy [J].Jpen Journal of Parenteral&Enteral Nutrition,2013,37 (5):641.
[6]Marvin R G,Mckinley B A,Mcquiggan M,et al.Nonocclusive bowel necrosis occurring in critically ill trauma patients receiving enteral nutrition manifests no reliable clinical signs for early de- tection[J].American Journal of Surgery,2000,179(1):7.
[7]Wells DL.Provision of enteral nutrition during vasopressor therapy for hemodynamic instability:an vidence~based review[J]. Nutr Clin Prac,2012,27(4):521-526.
[8]Flordel侏s Lasierra JL,P佴rez~Vela JL,Umezawa Makikado LD,et al.Early enteral nutrition in patients with hemodynamic failure following cardiac surgery [J].JPEN J Parenter Enteral Nutr, 2015,39(2):154-162.
[9]杨硕菲,虞文魁,黎介寿.危重症病人血流动力学不稳定时的 早期肠内营养支持[J].肠外与肠内营养,2014,21(04):247~250.
[10]Matheson PJ,Wilson MA,Garrison RN.Regulation of in- testinal blood flow[J].J Surg Res,2000,93(1):182-196.
[11]Cresci G,Cue J.The patient with circulatory shock: to feed or not to feed [J].Nutrition in Clinical Practice Official Publica- tion of the American Society for Parenteral&Enteral Nutrition, 2008,23(5):501.
[12]Nguyen NQ,Chapman MJ,Fraser RJ,et al.The effects of se- dation on gastric emptying and intragastric meal distribution in critical illness[J].Intensive Care Med,2008,34(37):454-460.
[13]Tamion F,Hamelin K,Duflo A,et al.Gastric emptying in me- chanically ventilated critically ill patients:effect of neuromuscular blocking agent[J].Intensive Care Med,2003,29(10):1717-1722.
[14]Saur J,Leweling H,Trinkmann F,et al.Modification of the Harris-Benedict equation to predict the energy requirements of critically ill patients during mild therapeutic hypothermia [J].In Vivo(Brooklyn),2008,22(1):143-146.
[15]Oshima T,Furukawa Y,Kobayashi M,et al.Fulfilling caloric demands according to indirect calorimetry may be beneficial for post cardiac arrest patients under therapeutic hypothermia[J].Re- suscitation,2015(88):81-85.
[16]Bernard SA,MacC Jones B,Buist MD.Experience with pro- longed induced hypothermia in severe head injury [J].Crit Care, 1999,3(6):167-172.
[17]Bernard SA,Buist M.Induced hypothermia in critical care medicine:a review[J].Crit Care Med,2003,31(7):2041-2051.
[18]Williams ML,Nolan JP.Is enteral feeding tolerated during therapeutic hypothermia [J].Resuscitation,2014,85 (11):1469 - 1472.
[19]曾明民.早期不同营养支持在重症监护病房患者康复中的 应用效果[J].临床合理用药杂志,2017,10(06):68-69.
[20]陈以明,吴海宾,廖梅嫣,等.肠内营养实施时机对脓毒性休 克预后影响[J].数理医药学杂志,2015,28(12):1774-1775.
[21]Gottschlich M,Jenkins M,Mayes T,et al.The 2002 Clinical Research Award:An evaluation of the safety of early vs delayed enteral support and effects on clinical,nutritional,and endocrine outcomes after severe burns[J].J Burn Care Rehabil,2002,239(3): 401-415.
[22]Mosier M J,Pham T N,Klein M B,et al.Early enteral nutri- tion in burns:compliance with guidelines and associated out- comes in a multicenter study [J].Journal of Burn Care&Research Official Publication of the American Burn Association,2011,32 (1):104.
[23]杜红妍,王丽,刘小晶,等.早期肠内营养支持对危重症脑卒 中患者营养状况和并发症的影响[J].中国实用神经疾病杂志, 2016,19(04):75-76,142.
[24]赵金霞.早期肠内营养预防脑出血术后应激性溃疡的临床 研究[J].中西医结合心脑血管病杂志,2015,13(01):121-122.
[25]Dennis MS,Lewis SC,Warlow C,et al.Effect of timing and method of enteral tube feeding for dysphagic stroke patients (FOOD):a multicentre randomised controlled trial [J].Lancet 2005,365(9461):764-772.
[26]Xueping,Fengbo Ma,Kezhi Jia.Early Enteral Nutrition with- in 24 Hours or between 24 and 72 Hours for Acute Pancreatitis: Evidence Based on 12 RCTs [J].Medical Science Monitor:In- ternational Medical Journal of Experimental and Clinical Re- search,2014,20: 2327-2335.
[27]Sun JK,Li WQ,Ke L,et al.Early enteral nutrition prevents in- tra-abdominal hypertension and reduces the severity of severe acute pancreatitis compared with delayed enteral nutrition:a prospective pilot study[J].World J Surg,2013(37):2053-2060.
[28]黄海波.胃肠手术后早期肠内营养支持对患者康复影响分 析[J].中国医药指南,2012,10(03):211-212.
[29]徐月华.胃肠手术后患者实施早期肠内营养治疗的效果观 察[J].中国医药科学,2015,5(18):105-107.
[30]Polk TM,Schwab CW.Metabolic and nutritional support of the enterocutaneous fistula patient:a three -phase approach [J]. World J Surg,2012,36(3):524-533.
[31]Khoshbaten M,Ghaffarifar S,Jabbar Imani A,et al.Effects of early oral feeding on relapse and symptoms of upper gastroin- testinal bleeding in peptic ulcer disease[J].Dig Endosc,2013,25(2): 125-129.
[32]Marik PE,Vasu T,Hirani A,et al.Stress ulcer prophylaxis in the new millennium:a systematic review and meta -analysis [J]. Crit Care Med,2010,38(11):2222-2228.
[33]Raff T,Germann G,Hartmann B.The value of early enteral nutrition in the prophylaxis of stress ulceration in the severely burned patient[J].Burns,1997,23(4):313-318.
[34]MacLaren R,Jarvis CL,Fish DN.Use of enteral nutrition for stress ulcer prophylaxis[J].Ann Pharmacother,2001,35(12):1614- 1623.
[35]Pilkington KB,Wagstaff MJ,Greenwood JE.Prevention of gastrointestinal bleeding due to stress ulceration:a review of cur- rent literature[J].Anaesth Intensive Care,2012,40(2):253-259.
[36]Cook D,Heyland D,Griffith L,et al.Risk factors for clinically important upper gastrointestinal bleeding in patients requiring mechanical ventilation.Canadian Critical Care Trials Group [J]. Crit Care Med,1999,27(12):2812-2817.
[37]H佴buterne X,Vanbiervliet G.Feeding the patients with up- per gastrointestinal bleeding [J].Curr Opin Clin Nutr Metab Care,2011,14(2):197-201.

相似文献/References:

[1]周 涛.含膳食纤维肠内营养在脑出血术后患者中的价值分析[J].医学信息,2018,31(10):111.[doi:10.3969/j.issn.1006-1959.2018.10.035]
　ZHOU Tao.Analysis of the Value of Dietary Fiber Enteral Nutrition in Postoperative Patients with Cerebral Hemorrhage[J].Journal of Medical Information,2018,31(01):111.[doi:10.3969/j.issn.1006-1959.2018.10.035]
[2]应结草.急性胰腺炎治疗的研究[J].医学信息,2018,31(14):32.[doi:10.3969/j.issn.1006-1959.2018.14.011]
　YING Jie-cao.Study of the Treatment of Acute Pancreatitis[J].Journal of Medical Information,2018,31(01):32.[doi:10.3969/j.issn.1006-1959.2018.14.011]
[3]谢 鹏,曹海泉,尚 娟,等.重症急性胰腺炎患者肠内营养的时机选择[J].医学信息,2018,31(17):81.[doi:10.3969/j.issn.1006-1959.2018.17.024]
　XIE Peng,CAO Hai-quan,SHANG Juan,et al.Timing of Enteral Nutrition in Patients with Severe Acute Pancreatitis[J].Journal of Medical Information,2018,31(01):81.[doi:10.3969/j.issn.1006-1959.2018.17.024]
[4]刘庆宪,罗 虹,冯妙莲,等.补中健脾法对老年营养不良患者身体质量指数和相关蛋白质物质治疗价值的临床研究[J].医学信息,2018,31(21):152.[doi:10.3969/j.issn.1006-1959.2018.21.044]
　LIU Qing-xian,LUO Hong,FENG Miao-lian,et al.Clinical Study on the Therapeutic Value of Body Mass Iindex and Related Protein in Elderly Patients with Malnutrition by Invigorating the Spleen Method[J].Journal of Medical Information,2018,31(01):152.[doi:10.3969/j.issn.1006-1959.2018.21.044]
[5]邱 夏,江 涛,邹 标.早期肠内营养与肠外营养对应激性溃疡患者CRP水平的影响研究[J].医学信息,2021,34(21):58.[doi:10.3969/j.issn.1006-1959.2021.21.014]
　QIU Xia,JIANG Tao,ZOU Biao.Effect of Early Enteral Nutrition and Parenteral Nutrition on CRP Level in Patients with Stress Ulcer[J].Journal of Medical Information,2021,34(01):58.[doi:10.3969/j.issn.1006-1959.2021.21.014]
[6]陈善炜,杜国平.多功能胃肠管在上消化道内镜黏膜下剥离术后的应用[J].医学信息,2021,34(22):40.[doi:10.3969/j.issn.1006-1959.2021.22.011]
　CHEN Shan-wei,DU Guo-ping.Application of Multifunctional Gastrointestinal Tube After Upper Gastrointestinal Endoscopic Submucosal Dissection[J].Journal of Medical Information,2021,34(01):40.[doi:10.3969/j.issn.1006-1959.2021.22.011]
[7]候小芹,唐浪娟,晏萍兰.儿童鼻肠管的应用研究[J].医学信息,2020,33(07):52.[doi:10.3969/j.issn.1006-1959.2020.07.016]
　HOU Xiao-qin,TANG Lang-juan,YAN Ping-lan.Applied Research of Nasointestinal Tube in Children[J].Journal of Medical Information,2020,33(01):52.[doi:10.3969/j.issn.1006-1959.2020.07.016]
[8]娄侠儒,吴 翔,胡桂芳,等.早期幽门后喂养在重症脑血管疾病患者中的应用价值[J].医学信息,2020,33(13):90.[doi:10.3969/j.issn.1006-1959.2020.13.024]
　LOU Xia-ru,WU Xiang,HU Gui-fang,et al.Application Value of Early Post-pyloric Feeding in Patients with Severe Cerebrovascular Disease[J].Journal of Medical Information,2020,33(01):90.[doi:10.3969/j.issn.1006-1959.2020.13.024]
[9]周 强,刘 波.持续与间断肠内营养对创伤性肠破裂患者术后喂养不耐受的比较研究[J].医学信息,2021,34(01):105.[doi:10.3969/j.issn.1006-1959.2021.01.027]
　ZHOU Qiang,LIU Bo.A Comparative Study of Continuous and Intermittent Enteral Nutrition on Postoperative Feeding Intolerance in Patients with Traumatic Intestinal Rupture[J].Journal of Medical Information,2021,34(01):105.[doi:10.3969/j.issn.1006-1959.2021.01.027]
[10]王跃生,赵铁锁.可溶性膳食纤维对儿童急性胰腺炎胃肠功能的影响[J].医学信息,2022,35(23):104.[doi:10.3969/j.issn.1006-1959.2022.23.019]
　WANG Yue-sheng,ZHAO Tie-suo.Effect of Soluble Dietary Fiber on Gastrointestinal Function in Children with Acute Pancreatitis[J].Journal of Medical Information,2022,35(01):104.[doi:10.3969/j.issn.1006-1959.2022.23.019]
[11]刘 颖,杨志高,李慧琼,等.肠内联合肠外营养与肠内营养支持治疗COPD机械通气患者疗效比较的Meta分析[J].医学信息,2022,35(10):98.[doi:10.3969/j.issn.1006-1959.2022.10.024]
　LIU Ying,YANG Zhi-gao,LI Hui-qiong,et al.Meta-analysis of the Efficacy of Enteral Combined Parenteral Nutrition and Enteral Nutrition Support in the Treatment of COPD Patients with Mechanical Ventilation[J].Journal of Medical Information,2022,35(01):98.[doi:10.3969/j.issn.1006-1959.2022.10.024]

更新日期/Last Update: 2018-01-22