摘要
医学营养治疗影响脓毒症患者的预后,但是临床实施过程存在争议。为进一步规范脓毒症患者医学营养治疗,中华医学会肠外肠内营养学分会(CSPEN)组织国内50余位重症医学、临床营养学、循证医学和统计学专家,按照推荐意见分级评价、制定与评估(GRADE)系统的标准和流程,通过系统性检索与证据梳理,并结合临床专家的实践经验制订本指南。指南针对脓毒症患者医学营养治疗中的营养风险筛查、早期医学营养治疗(肠内营养、肠外营养、能量供给、最佳目标蛋白质供给)、肠内营养治疗的输注方式、中医与肠道功能、营养补充剂(维生素、谷氨酰胺、ω‑3脂肪酸、硒)、益生菌、质子泵抑制剂的使用等方面作出了相应的推荐意见,最终形成14个问题、14条推荐意见,以期完善脓毒症患者医学营养治疗流程。
Although medical nutritional therapy affects the prognosis of sepsis patients,there is controversy over its clinical implementation process.To further standardize the medical nutrition therapy of sepsis patients,the Chinese Society of Parenteral and Enteral Nutrition(CSPEN)organized more than 50 experts from critical care medicine,clinical nutrition,evidence based medicine and statistics to formulate the guidelines.The guideline was based on grading of recommendations,development and evaluations(GRADE)standards and procedures,through systematic retrieval and evidence sorting,and combined with the practical experience of clinical experts.The guidelines provide recommendations on nutritional risk screening in medical nutrition therapy for sepsis patients,early medical nutrition therapy(enteral nutrition,parenteral nutrition,energy intake,optimal target for protein delivery),enteral nutrition infusion mode,traditional Chinese medicine and protecting intestinal function,nutritional supplements(vitamin,glutamine,omega‑3 fatty acids,selenium),probiotics,and the use of proton pump inhibitors.Ultimately,14 questions and 14 recommendations were formed in order to improve the medical nutrition therapy process for sepsis patients.
出处
《中华医学杂志》
北大核心
2025年第7期510-528,共19页
National Medical Journal of China
基金
国家自然科学基金(82272234、82270087、82372203)
上海申康医院发展中心临床科学技术创新计划(SHDC22021316、SHDC22023218)。
关键词
脓毒症
重症医学
医学营养治疗
营养风险筛查
蛋白质供给
能量供给
Sepsis
Critical care medicine
Medical nutritional therapy
Nutritional risk screening
Protein delivery
Energy intake
