最新ESPEN家庭肠内营养实践指南解读2022（全文）
中学生发型女
本期导读
贲字怎么读2022年2月1日，欧洲临床营养与代谢协会（European Society for Clinical Nutrition and Metabolism, ESPEN）在其官方杂志Clinical Nutrition上正式发表了ESPEN家庭肠内营养实践指南（ESPEN practical guideline: Home enteral nutrition）。该指南从临床实用性出发，对2020年发表的ESPEN家庭肠内营养指南进行缩减，从家庭肠内营养适应证、禁忌证到如何实施和监测以及防治并发症，总计给出61条推荐，并添加了流程图，更加便于临床医师、营养师及护士等在临床实践中使用。
一、家庭肠内营养适应证和禁忌证
Fig.1. 家庭肠内营养适应证和禁忌证
1. 家庭肠内营养适应证和禁忌证 (Fig.1)
1.1. 家庭肠内营养适应证
梦见喝汤
推荐1
HEN should be offered to patients at nutritional risk or malnourished who cannot meet their nutrient requirements by normal dietary intake, who have a functioning gastrointestinal tract, who are able to receive therapy outside of an acute care tting, and who agree and are able to comply with HEN therapy with the goal of improving body weight, functional status or QoL. (Grade GPP, strong connsus 97%)
应向有营养风险或营养不良的患者提供HEN，这些患者无法通过正常饮食满足营养摄入需求，但胃肠道功能正常，能够在急症情形以外接受治疗，同意并能够遵守HEN治疗，以达到改善体重，功能状态或生
活质量的目标。（推荐等级GPP - 强烈同意97％）
推荐2
Prior to discharge from hospital of patients at risk of malnutrition (e.g. patients with neurological dia, head injury, head and neck cancer, gastrointestinal and other malig
nancies, non-neoplastic gastrointestinal dia including malabsorptive syndromes), either oral nutritional supplements or HEN should be considered. (Grade B, strong connsus 96%)
有营养不良风险的患者（例如神经系统疾病，头部损伤，头颈肿瘤，胃肠道和其他恶性肿瘤，非肿瘤性胃肠道疾病包括吸收不良综合征）出院前，应考虑口服营养补充剂或HEN。（推荐等级B - 强烈同意96％）
1.2. 家庭肠内营养禁忌证
营业执照怎么查推荐3
If life expectancy is estimated to be less than one month, HEN usually shall not be initiated.(Grade GPP, connsus 78%)
如果预期寿命不到一个月，通常不应实施HEN。（推荐等级GPP – 同意78％）
入党政审
推荐4
HEN shall not be performed in patients with contraindications such as vere functional disturbances of the bowel, gastrointestinal obstruction, gastrointestinal tract bleeding, vere malabsorption or vere metabolic imbalances. (Grade GPP, connsus 84%)
对存在严重肠功能障碍，胃肠道梗阻，胃肠道出血，严重吸收不良或严重代谢失衡等禁忌证患者，不应实施HEN。（推荐等级GPP – 同意84％）快乐春节作文
推荐5
If patient and/or their legal carers do not to agree to a HEN program or are unlikely to comply with and/or if there are organizational/logistic problems which cannot be overcome, HEN should not be offered. (Grade GPP, strong connsus 97%)
如果患者和/或其法定照护人员不同意HEN计划，或不太可能遵守HEN计划，和/或存在无法克服的组织/后勤问题，则不应实施HEN。（推荐等级GPP - 强烈同意97％）
二、家庭肠内营养的喂养通路
Fig.2. 家庭肠内营养的喂养通路
2.1. 喂养管设备 (Fig.2)
2.1.1. 短期家庭肠内营养 (<6周)
wps云空间
推荐6
HEN can be delivered through a nasal feeding tube in patients who need HEN only for a short period of time (up to 4 - 6 weeks). (Grade 0, connsus 90%)
仅需短期HEN的患者（最多4-6周）可以使用鼻饲管实施HEN。（推荐等级0 - 同意90％）
2.1.2. 长期家庭肠内营养 (>6周)
孔窍推荐7
A PEG or, if indicated, a percutaneous endoscopic jejunostomy (PEJ) is the preferred access device and should be placed when long-term HEN is required.(Grade B, strong connsus 93%)
