中国成人患者肠外肠内营养临床应用指南（2023版）

·946·中华医学杂志2023年4月4日第103卷第13期Natl Med J China,Apil4,2023,Val.103.No.13·标准与规范·中国成人患者肠外肠内营养临床应用指南(2023版)中华医学会肠外肠内营养学分会道信作者：杨桦，重庆市人民医院普外科，重庆400037，Email:hwbyang(@126.com;朱明炜，北京医院普外科国家老年医学中心中国医学科学院老年医学研究院，北京100730,Email:zhumw.2013@163.com;陈伟，中国医学科学院北京协和医学院北京协和医院临床营养科，北京l00730,Email:txchenwei@sina.com;王新颖，东部战区总医院普外科，南京210002，Email:wangxinying@nju.edu.cn【摘要】营养不良是指由于摄入不足或利用障碍引起能量或营养素缺乏的状态，是导致不良临床结局的主要因素。为进一步规范营养支持治疗流程，由中华医学会肠外肠内营养学分会(C$PEN)组织国内近百位相关领域的专家，基于现有的循证医学证据，围绕以下主题进行阐述：营养筛查及评估；营养不良的诊断及监测；营养支持治疗的诊疗流程、供能目标及卫生经济学效益；肠内营养(EN)和肠外营养(PN)的适应证、启动时机、输注方式及配方的选择：营养支持治疗耐受性的监测、并发症的预防及管理等，最终提出37个问题、60条推荐意见，旨在为肠外肠内营养的临床规范应用提供参考。【关键词】肠外营养；肠内营养；成人；营养筛查；营养评估：临床指南基金项目：国家重点研发计划(2022Y下A1304004):中国医学科学院医学与健康科技创新工程(2021-I2M-C&T-B-094)实践指南注册：国际实践指南注册与透明化平台(IPGRP-2022CN155)Guideline for clinical application of parenteral and enteral nutrition in adults patients inChina (2023 edition)Chinese Society of Parenteral and Enteral Nutrition(CSPEN)Corresponding authors:Yang Hua,Department of General Surgery,Chongqing General Hospital,Chongqing 400037,China,Email:hwbyang@126.com;Zhu Mingwei,Department of General Surgery,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy ofMedical Sciences,Beijing 100730,China,Email:zhumw2013@163.com;Chen Wei,Department ofClinical Nutrition,Chinese Academy of Medical Sciences,Peking Union Medical College Hospital,Beijing100730,China,Email:txchenwei@sina.com;Wang Xinying,Department of General Surgery Nutrition,General Hospital of Eastern Theater Command,Nanjing 210002,China,Email:wangxinying @nju.edu.cnAbstract]Malnutrition refers to the state of energy or nutrient deficiency caused byinsufficient intake or utilization,which is the main factor leading to adverse clinical outcomes.Inorder to further standardize the nutritional support treatment process,nearly 100 experts in relatedfields were organized by the Chinese Society of Parenteral and Enteral Nutrition (CSPEN)toelaborate on the following topics based on the existing evidence-based medical evidence:nutritionalscreening and assessment;diagnosis and monitoring of malnutrition;diagnosis and treatmentprocess,energy targets and health economic benefits of nutritional support therapy;indication,D0L:10.3760/cmaj.cm112137-20221116-02407收稿日期2022-11-16本文编辑朱冬冬引用本文：中华医学会肠外肠内营养学分会.中国成人患者肠外肠内营养临床应用指南(2023版)[中华医学杂志，2023,103(13946-974.D01:10.3760/cmaj.cml12137-20221116-02407.