切换至 "中华医学电子期刊资源库"

中华损伤与修复杂志(电子版) ›› 2020, Vol. 15 ›› Issue (05) : 337 -340. doi: 10.3877/cma.j.issn.1673-9450.2020.05.002

所属专题: 文献

专家述评

肠外营养技术的进步
朱明炜1,(), 刘承宇1   
  1. 1. 100730 北京医院肝胆胰外科 国家老年医学中心 中国医学科学院老年医学研究院
  • 收稿日期:2020-08-20 出版日期:2020-10-01
  • 通信作者: 朱明炜

Advances in parenteral nutrition technology

Mingwei Zhu1,(), Chengyu Liu1   

  1. 1. Department of Hepatobiliary and Pancreatic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
  • Received:2020-08-20 Published:2020-10-01
  • Corresponding author: Mingwei Zhu
  • About author:
    Corresponding author: Zhu Mingwei, Email:
引用本文:

朱明炜, 刘承宇. 肠外营养技术的进步[J]. 中华损伤与修复杂志(电子版), 2020, 15(05): 337-340.

Mingwei Zhu, Chengyu Liu. Advances in parenteral nutrition technology[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2020, 15(05): 337-340.

肠外营养是胃肠道功能严重障碍和(或)肠内营养不能满足能量需求的各类患者必需的治疗手段。近年来,肠外营养技术的进步可以体现在理念(补充性肠外营养)、配方(优化营养素组成)、制剂(工业化的多腔袋)等3个方面。补充性肠外营养的核心是在肠内营养基础上的肠外营养,既维护肠屏障功能,又能较快达到目标喂养量,满足机体代谢需求。优化营养素组成,充分发挥不同营养素的药理作用,进行代谢调理,维护器官功能。工业化生产的多腔袋肠外营养制剂,符合"全合一"的理念,使用方便,可减少处方和配置差错,降低感染并发症和医疗费用,适合病情稳定和短期应用肠外营养的患者。

Parenteral nutrition is a necessary treatment for patients with severe gastrointestinal dysfunction and (or) failure of enteral nutrition to meet their energy needs. In recent years, the progress of parenteral nutrition technology can be reflected in three aspects: concept (supplemental parenteral nutrition), formulation (optimization of nutrient composition) and preparation (industrial multi-cavity bag). The core of supplemental parenteral nutrition is parenteral nutrition based on enteral nutrition, which can not only maintain the intestinal barrier function, but also achieve the target amount of feeding quickly and meet the metabolic needs of the body. Optimize the composition of nutrients, give full play to the pharmacological effects of different nutrients, carry out metabolic conditioning, and maintain organ functions. The industrialized multi-cavity bag parenteral nutrition preparation conforms to the concept of "All-in-one" , is convenient to use, can reduce prescription and configuration error, reduce infectious complications and medical costs, and is suitable for patients with stable condition and short-term application of parenteral nutrition.

[1]
黎介寿. 临床营养支持的发展趋势[J]. 肠外与肠内营养,2010, 17(1): 1-4.
[2]
Taylor BE, McClave SA, Martindale RG, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)[J]. Crit Care Med, 2016, 44(2): 390-438.
[3]
Heyland DK, Dhaliwal R, Wang M, et al. The prevalence of iatrogenic underfeeding in the nutritionally 'at-risk’ critically ill patient: Results of an international, multicenter, Prospective study[J]. Clin Nutr, 2015, 34(4): 659-666.
[4]
周华,杜斌,柴文昭,等. 我国危重症病人营养支持现状调查分析[J]. 肠外与肠内营养,2009, 16(5): 259-268.
[5]
Alberda C, Gramlich L, Jones N, et al. The relationship between nutritional intake and clinical outcomes in critically ill patients: results of an international multicenter observational study[J]. Intensive Care Med, 2009, 35(10): 1728-1737.
[6]
Cederholm T, Barazzoni R, Austin P, et al. ESPEN guidelines on definitions and terminology of clinical nutrition[J]. Clin Nutr, 2017, 36(1): 49-64.
[7]
Weijs PJ, Looijaard WG, Beishuizen A, et al. Early high protein intake is associated with low mortality and energy overfeeding with high mortality in non-septic mechanically ventilated critically ill patients[J]. Crit Care, 2014, 18(6): 701.
[8]
Heidegger CP, Berger MM, Graf S, et al. Optimisation of energy provision with supplemental parenteral nutrition in critically ill patients: a randomised controlled clinical trial[J]. Lancet, 2013, 381(9864): 385-393.
[9]
Casaer MP, Mesotten D, Hermans G, et al. Early versus late parenteral nutrition in critically ill adults[J]. N Engl J Med, 2011, 365(6): 506-517.
[10]
Doig GS, Simpson F, Sweetman EA, et al. Early parenteral nutrition in critically ill patients with short-term relative contraindications to early enteral nutrition: a randomized controlled trial[J]. JAMA, 2013, 309(20): 2130-2138.
[11]
Reignier J, Boisramé-Helms J, Brisard L, et al. Enteral versus parenteral early nutrition in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2)[J]. Lancet, 2018, 391(10116): 133-143.
[12]
Jie B, Jiang ZM, Nolan MT, et al. Impact of preoperative nutritional support on clinical outcome in abdominal surgical patients at nutritional risk[J]. Nutrition, 2012, 28(10): 1022-1027.
[13]
Heyland DK, Dhaliwal R, Jiang X, et al. Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool[J]. Crit Care, 2011, 15(6): R268.
[14]
中华医学会肠外肠内营养学分会. 成人补充性肠外营养中国专家共识[J]. 中华胃肠外科杂志,2017, 20(1): 9-13.
[15]
中华医学会肠外肠内营养学分会老年营养支持学组. 中国老年患者肠外肠内营养应用指南(2020)[J].中华老年医学杂志,2020, 39(2): 119-132.
[16]
Wischmeyer PE, Dhaliwal R, McCall M, et al. Parenteral glutamine supplementation in critical illness: a systematic review[J]. Crit Care, 2014, 18(2): R76.
[17]
Yong L, Lu QP, Liu SH, et al. Efficacy of Glutamine-Enriched Nutrition Support for Patients With Severe Acute Pancreatitis: A Meta-Analysis[J]. JPEN J Parenter Enteral Nutr, 2016, 40(1): 83-94.
[18]
李潇潇,蒋朱明,翟所迪,等. 鱼油(ω-3脂肪酸)对手术后患者感染并发症、成本/效果影响的系统评价(2010~2016)[J]. 中华临床营养杂志,2016, 24(6): 323-331.
[19]
Lei QC, Wang XY, Xia XF, et al. The role of omega-3 fatty acids in acute pancreatitis: a meta-analysis of randomized controlled trials[J]. Nutrients, 2015, 7(4): 2261-2273.
[20]
丛明华,宋晨鑫,邹宝华,等. 谷氨酰胺、EPA、支链氨基酸对食管癌同步放化疗及胃癌术后辅助化疗患者的影响[J]. 中华医学杂志,2015, 95(10): 766-769.
[21]
Dai YJ, Sun LL, Li MY, et al. Comparison of Formulas Based on Lipid Emulsions of Olive Oil, Soybean Oil, or Several Oils for Parenteral Nutrition: A Systematic Review and Meta-Analysis[J]. Adv Nutr, 2016, 7(2): 279-286.
[22]
Tian H, Yao X, Zeng R, et al. Safety and efficacy of a new parenteral lipid emulsion (SMOF) for surgical patients: a systematic review and meta-analysis of randomized controlled trials[J]. Nutr Rev, 2013, 71(12): 815-821.
[23]
Pan H, Cai S, Ji J, et al. The impact of nutritional status, nutritional risk, and nutritional treatment on clinical outcome of 2248 hospitalized cancer patients: a multi-center, prospective cohort study in Chinese teaching hospitals[J]. Nutr Cancer, 2013, 65(1): 62-70.
[24]
Turpin RS, Solem C, Pontes-Arruda A, et al. The impact of parenteral nutrition preparation on bloodstream infection risk and costs[J]. Eur J Clin Nutr, 2014, 68(8): 953-958.
[25]
Turpin RS, Canada T, Rosenthal V, et al. Bloodstream infections associated with parenteral nutrition preparation methods in the United States: a retrospective, large database analysis[J]. JPEN J Parenter Enteral Nutr, 2012, 36(2): 169-176.
[26]
Pontes-Arruda A, Dos Santos MC, Martins LF, et al. Influence of parenteral nutrition delivery system on the development of bloodstream infections in critically ill patients: an international, multicenter, prospective, open-label, controlled study--EPICOS study[J]. JPEN J Parenter Enteral Nutr, 2012, 36(5): 574-586.
[27]
詹文华,蒋朱明,唐云,等. 低氮低热量肠外营养对胃手术后患者结局的影响:120例随机对照多中心临床研究[J]. 中华医学杂志,2007, 87(25): 1729-1733.
[28]
Berlana D, Sabin P, Gimeno-Ballester V, et al. Cost analysis of adult parenteral nutrition systems: three-compartment bag versus customized[J]. Nutr Hosp, 2013, 28(6): 2135-2141.
[1] 田瑞霞. 胎儿肝脏局灶性结节性增生的声像图特征与临床结局分析[J]. 中华医学超声杂志(电子版), 2020, 17(11): 1148-1148.
[2] 李磊, 刘鹏, 李明, 赵婉妮, 潘琦, 朱明炜, 韦军民. 胰岛素在多腔袋肠外营养液中的稳定性研究[J]. 中华损伤与修复杂志(电子版), 2020, 15(03): 231-234.
[3] 王艳, 许静涌, 崔红元, 朱赛楠, 朱明炜, 韦军民. 老年慢性心血管疾病患者营养状态与临床结局的相关性研究[J]. 中华损伤与修复杂志(电子版), 2018, 13(03): 209-214.
[4] 朱青, 马洁, 戴尧, 庞明泉, 樊海宁, 崔红元. 多房棘球蚴病患者营养评估及干预措施[J]. 中华肝脏外科手术学电子杂志, 2023, 12(03): 356-359.
[5] 于明基, 赵延辉, 李雪婷, 尤伟艳, 许航, 任珊. 最高SOFA评分对G/G-主要致病菌致脓毒症患者临床结局的预测[J]. 中华重症医学电子杂志, 2020, 06(01): 71-76.
[6] 黄婷萍, 王广川, 黄广军, 张春清. 基于机器学习算法的肝硬化患者经颈静脉肝内门体分流术后临床结局预测[J]. 中华消化病与影像杂志(电子版), 2022, 12(01): 4-10.
[7] 肖士鹏, 徐帅, 李士春, 云才. T1倾斜角-颈椎前凸角(T1S-CL)在三节段颈椎前路椎间盘切除融合术中的意义[J]. 中华临床医师杂志(电子版), 2022, 16(06): 558-565.
[8] 朱敏, 李法强. 血清GFAP、UCH-L1联合VILIP-1水平对急性脑梗死神经功能预后不良的预测研究[J]. 中华脑血管病杂志(电子版), 2023, 17(05): 452-457.
阅读次数
全文


摘要