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神经系统疾病肠内营养支持操作规范共识(2011版)

percutanoous endoscopic gastrostomy and nasogastric tube feeding in patients with persisting neurological dysphagia. BMJ, 1992, 304:1406-1409.

@@[19] Dwolatzky T, Berezovski S, Friedmann R, et al. A prospective comparison of the use of nasogastric and percutaneous endoscopic gastrostomy tubes for long-term enteral feeding in older people. Clin Nutr, 2001, 20:535-540.

@@[20] Baeten C, Hoofnagels J. Feeding via nasogastric tube or percutaneous endoscopic gastrostomy. A comparison. Scand J Gastroenterol Suppl, 1992, 194:95-98.

@@[21] Katzberg HD, Benatar M. Enteral tube feeding for amyotrophic lateral sclerosis/motor neuron disease. Cochrane Database Syst Rev, 2011 :CD004030.

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@@[23] Brocker P, Benhamidat T, Benoit M, et al. Nutritional status and Alzheimer' s disease: preliminary results of the REAL. FR study. Rev Med Interne, 2003, 24 Suppl 3:313-318.

@@[ 24 ] Faxen-Irving G, Basun H, Cederholm T. Nutritional and cognitive relationships and long-term mortality in patients with various dementia disorders. Age Ageing, 2005, 34:136-141.

@@[25] Shatenstein B, Kergoat MJ, Reid I. Poor nutrient intakes during 1-year follow-up with community-dwelling older adults with early stage Alzheimer dementia compared to cognitively intact matched controls. J Am Diet Assoc, 2007, 107:2091-2099.@@[26] Hanson LC, Ersek M, Gilliam R, et al. Oral feeding options for people with dementia: a systematic review. J Am Geriatr Soo,

2011,59:463-472.

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2011-07-05

神经系统疾病肠内营养支持操作规范共识(2011版)

中华医学会肠外肠内营养学分会神经疾病营养支持学组

一、营养风险筛查

背景与证据:神经系统疾病伴吞咽障碍患者进食减少或不能进食,危重神经疾病患者分解代谢大于合成代谢,部分神经疾病患者病前就已经存在营养不足或营养风险。因此有必要进行营养风险筛查(nutrition risk screening,NRS,表1),以确定进一步的营养评估和营养支持方案。2003年Kondrup等[2 ]对128个有关营养支持的随机对照研究进行了系统分析,经NRS2002筛查的8944例患者中,总分≥3分并予以营养支持的,良好结局比例明显增高(P =0.000,Ⅰ a级证据)。2003年欧洲肠外肠内营养学会(European Society for Parenteral and Enteral Nutrition,ESPEN)、2006年中华医学会肠外肠内营养学分会(Chinese Society of Parenteral and Enteral Nutrition,CSPEN)和2011年美国肠外肠内营养学会( American Society for Parenteral and Enteral Nutrition, ASPEN)均推荐住院患者使用营养风险筛查工具[3-5]。由于NRS2002简便易用,又有循证医学支持证据,2005年至2006年北京3家三级甲等医院神经内科对住院患者应用NRS2002进行了营养风险筛查,在753例住院患者中,461例(61.2%)完成了筛查,营养不足和营养风险的发生率分别为4.2%和21.2%,有营养风险的患者仅14. 4%接受营养支持[6](Ⅲb级证据)。由此说明,即便大城市的大医院也存在营养风险率较高和营养支持率较低的现状。因此,有必要将营养风险筛查纳入神经系统疾病营养支持操作规范,以加强住院患者营养支持管理。

10. 3760/cma. j. issn. 1006-7876. 2011.11.018万方数据

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九、肠内营养支持调整

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@@[1]宿英英,黄旭升,彭斌,等.神经系统疾病肠内营养支持操作规 范共识.中华神经科杂志,2009,42:788-791.

@@[2] Kondrup J, Rasmussen HH, Hamberg O, et al. Nutritional risk screening ( NRS 2002 ) : a new method based on an analysis of controlled clinical trials. Clin Nutr, 2003, 22:321-336.@@[3] Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines for nutrition screening 2002. Clin Nutr, 2003, 22:415-421.

@@[4]中华医学会.临床诊疗指南-肠外肠内营养学分册(2008版). 北京:人民卫生出版社,2009:1 8-24.

@@[5] Mueller C, Compher C, Ellen DM. A. S. P. E. N. clinical guidelines: nutrition screening, assessment, and intervention in 

adults.J Parenter Enteral Nutr, 2011,35:16-24.@@[6]崔丽英,陈海波,宿英英,等.北京大医院神经科住院患者营养 风险、营养不足、超重和肥胖发生率及营养支持应用状况.中 国临床营养杂志,2009,17:67-70.

@@ [7] Krishnan JA, Parce PB, Martinez A, et al. Caloric intake in medical ICU patients: consistency of care with guidelines and relationship to clinical outcomes. Chest, 2003, 124:297-305.@@ [ 8 ] ASPEN Board of Directors and the Clinical Guidelines Task Force. Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. J Parenter Enteral Nutr, 2002, 26 (1 Suppl ) : 1-138.

@@ [9] Esper DH, Coplin WM, Carhuapoma JR. Energy expenditure in patients with nontraumatic intracranial hemorrhage. J Parenter Enteral Nutr, 2006, 30:71-75.

@@[10] Bardutzky J, Georgiadis D, Kollmar R, et al. Energy demand in patients with stroke who are sedated and receiving mechanical ventilation. J Neurosurg, 2004, 100:266-271.@@[11] Singer P, Berger MM, van den Berghe G, et at. ESPEN Guidelines on Parenteral Nutrition: intensive care. Clin Nutr, 2009, 28:387-400.

@@[ 12] Druml W, Jadma K. Recommendations for Parenteral Nutrition in Adults. Vienna: Austrian Society of clinical Nutrition ( AKE ), 2008 : 18-23.

@@[13] Su YY, Li X, Li SJ, et al. Predicting hospital mortality using APACHE Ⅱ scores in neurocritically ill patients: a prospective study. J Neurol, 2009, 256:1427-1433.

@@[ 14] Gramlich L, Kichian K, Pinilla J, et al. Does enteral nutrition compared to parenteral nutrition result in better outcomes in critically ill adult patients.? A systematic review of the literature. Nutrition ,2004, 20:843-848.

@@[ 15 ] Dennis MS, Lewis SC, Warlow C. Effect of timing and method of enteral tube feeding for dysphagic stroke patienls ( FOOD ) : a multicentre randomiscd controlled trial. Lancet, 2005, 365 : 764-

772.

@@[16] Minard G, Kudsk KA, Melton S, et al. Early versus delayed feeding with an immune-enhancing diet in patients with severe head injuries. J Parenter Enteral Nutr, 2000, 24:145-149.

@@[17] Elia M, Ceriello A, Laube H, et al. Enteral nutritional support and use of diabetes-specific formulas for patients with diabetes : a systematic review and meta-analysis. Diabetes Care, 2005, 28: 2267 -2279.

@@[18]高会霞,宿英英.等热量不同糖成分营养制剂对急性卒中患者 血糖影响的随机对照研究.中国临床营养杂志,2008,16:209- 210.

@@[19]周翠萍,宿英英.重症卒中患者对等热卡不同蛋白质入量的肠 内营养代谢反应:51例随机对照研究.中国临床营养杂志, 2006,14:351-355.

@@[20] Scheinkestel CD, Kar L, Marshall K, et al. Prospective randomized trial to assess caloric and protein needs of critically ill, anuric, ventilated patients requiring continuous renal replacement therapy. Nutrition, 2003, 19:909-916.

@@[21 ] Elia M, Engfer MB, Green CJ, et al. Systematic review and meta analysis: the clinical and physiological effects of fibre-containing enteral formulae. Aliment Pharmacol Ther, 2008, 27 : 120-145.

@@[22] Rushdi TA, Pichard C, Khater YH. Control of diarrhea by fiber enriched diet in ICU patients on enteral mitrition: a prospective randomized controlled trial. Clin Nutr, 2004, 23 : 1344-1352.

@@[23] Del Olmo D, Lopez del VT, Martinez de IP, et al. Fiber in enteral nutrition: systematic review of the literature. Nutr Hosp, 2004, 19 :167-174.

@@[24] Ho KM, Dobb GJ, Webb SA. A comparison of early gastric and post-pyloric feeding in critically ill patients: a meta-analysis. Intensive Care Med, 2006, 32:639-649.

@@[25] Acosta-Eseribano J, Femandez-Vivas M, Grau CT, et al. Gastric versus transpyloric feeding in severe traumatic brain injury: a 

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prospective, randomized trial. Intensive Care Med, 2010, 36: 1532-1539.

@@[26] Dwolatzky T, Berezovski S, Friedmann R, et al. A prospective comparison of the use of nasogastric and percutaneous endoscopic gastrostomy tubes for long-term enteral feeding in older people. Clin Nutr, 2001, 20:535-540.

@@[27] Metheny NA, Clouse RE, Chang YH, et al. Tracheobronchial aspiration of gastric contents in critically ill tube-fed patients: frequency, outcomes, and risk factors. Crit Care Med, 2006, 34:

1007-1015.

@@[28 ] Bankhead R, Boullata J, Brantley S, et al. Enteral nutrition practice recommendations. J Parenter Enteral Nutr, 2009, 33: 122-167.

@@[29] Shang E, Geiger N, Sturm JW, et al. Pump-assisted enteral nutrition can prevent aspiration in bedridden percutaneous endoscopic gastrostomy patients. J Parenter Enteral Nutr, 2004, 28 : 180-183.

@@[30] Adams HP, Del ZG, Alberts MJ, et al. Guidelines for the early management of adults with ischemic stroke. Stroke, 2007, 38: 1655-1711.

@@[31 ] European Stroke Organisation (ESO) Executive Committee, ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. Cerebrovasc Dis, 2008, 25: 457-507.

@@[32] Griesdale DE, de Souza RJ, van Dam RM, et al. Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data. CMAJ, 2009, 180:821-827.@@[33] Moghissi ES, Korytkowski MT, Dinardo M, et al. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Diabetes Care, 2009, 32 : 1119-1131.

@@[34] Amarenco P, Bogousslavsky J, Callahan AR, et al. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med, 2006, 355:549-559.

@@[35]洪忠新,华鑫,武力,等.对住院患者低胆固醇血症的调查与分 析.中国临床营养杂志,2008,16:22 -25.

@@[36] Vincent JL, Dubois MJ, Navickis RJ, et al. Hypoalbuminemia in acute illness: is there a rationale for intervention? A meta-analysis 

of cohort studies and controlled trials. Ann Surg, 2003, 237:319- 334.

@@[37] Dubois MJ, Orellana-Jimenez C, Melot C, et al. Albumin administration improves organ function in critically ill hypoalbuminemic patients: a prospective, randomized, controlled, pilot study. Crit Care Med, 2006, 34:2536-2540.@@[38]宿英英,高淑凤,车林海,等.急性脑损伤并发低白蛋白血症的 危险因素.中国危重病急救医学,2000,12:308 -309.@@[ 39 ] Guenter PA, Settle RG, Perlmutter S, el al. Tube feeding-related 

diarrhea in acutely ill patients. J Parenter Enteral Nutr, 1991, 15 : 277 -280.

@@[40] Booth CM, Heyland DK, Paterson WG. Gastrointestinal 

promotility drugs in the critical care setting: a systematic review of the evidence. Crit Care Med, 2002, 30 : 1429-1435.

@@[41 ] Martino R, Foley N, Bhogal S, et al. Dysphagia after stroke: 

incidence, diagnosis, and pulmonary complications. Stroke, 2005, 36:2756-2763.

2011-07-05

万方数据

神经系统疾病肠内营养支持操作规范共识(2011版)

作者:中华医学会肠外肠内营养学分会神经疾病营养支持学组

作者单位:

刊名:

中华神经科杂志

英文刊名:Chinese Journal of Neurology

年,卷(期):2011,44(11)

被引用次数:7次

参考文献(41条)

1.宿英英;黄旭升;彭斌神经系统疾病肠内营养支持操作规范共识[期刊论文]-中华神经科杂志 2009(11)

2.Kondrup J;Rasmussen HH;Hamberg O Nutritional risk screening(NRS 2002):a new method based on an analysis of controlled clinical trials[外文期刊] 2003(3)

3.Kondrup J;Allison SP;Elia M ESPEN guidelines for nutrition screening 2002[外文期刊] 2003(4)

4.中华医学会临床诊疗指南-肠外肠内营养学分册(2008版) 2009

5.Mueller C;Compher C;Ellen DM A.S.P.E.N.clinical guidelines:nutrition screening,assessment,and intervention in adults[外文期刊] 2011

6.崔丽英;陈海波;宿英英北京大医院神经科住院患者营养风险、营养不足、超重和肥胖发生率及营养支持应用状况[期刊论文]-中国临床营养杂志 2009(2)

7.Krishnan JA;Parce PB;Martinez A Caloric intake in medical ICU patients:consistency of care with guidelines and relationship to clinical outcomes[外文期刊] 2003

8.ASPEN Board of Directors and the Clinical Guidelines Task Force Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients 2002(1Suppl)

9.Esper DH;Coplin WM;Carhuapoma JR Energy expenditure in patients with nontraumatic intracranial hemorrhage[外文期刊] 2006(2)

10.Bardutzky J;Georgiadis D;Kollmar R Energy demand in patients with stroke who are sedated and receiving mechanical ventilation[外文期刊] 2004

11.Singer P;Berger MM;van den Berghe G ESPEN Guidelines on Parenteral Nutrition:intensive care[外文期刊] 2009(4)

12.Druml W;Jadma K Recommendations for Parenteral Nutrition in Adults 2008

13.Su YY;Li X;Li SJ Predicting hospital mortality using APACHE Ⅱ scores in neurocritically ill patients:a prospective study 2009

14.Gramlich L;Kichian K;Pinilla J Does enteral nutrition compared to parenteral nutrition result in better outcomes in critically ill adult patients.? A systematic review of the literature[外文期刊] 2004(10)

15.Dennis MS;Lewis SC;Warlow C Effect of timing and method of enteral tube feeding for dysphagic stroke

patienls(FOOD):a multicentre randomiscd controlled trial[外文期刊] 2005

16.Minard G;Kudsk KA;Melton S Early versus delayed feeding with an immune-enhancing diet in patients with severe head injuries[外文期刊] 2000

17.Elia M;Ceriello A;Laube H Enteral nutritional support and use of diabetes-specific formulas for patients with diabetes:a systematic review and meta-analysis[外文期刊] 2005(9)

18.高会霞;宿英英等热量不同糖成分营养制剂对急性卒中患者血糖影响的随机对照研究 2008

19.周翠萍;宿英英重症卒中患者对等热卡不同蛋白质入量的肠内营养代谢反应:51例随机对照研究 2006

20.Scheinkestel CD;Kar L;Marshall K Prospective randomized trial to assess caloric and protein needs of critically ill,anuric,ventilated patients requiring continuous renal replacement therapy[外文期刊] 2003(11/12)

21.Elia M;Engfer MB;Green CJ Systematic review and metaanalysis:the clinical and physiological effects of fibre-containing enteral formulae 2008

22.Rushdi TA;Pichard C;Khater YH Control of diarrhea by fiberenriched diet in ICU patients on enteral mitrition:a prospective randomized controlled trial[外文期刊] 2004

23.Del Olmo D;Lopez del VT;Martinez de IP Fiber in enteral nutrition:systematic review of the literature 2004

24.Ho KM;Dobb GJ;Webb SA A comparison of early gastric and post-pyloric feeding in critically ill patients:a meta-analysis[外文期刊] 2006

25.Acosta-Eseribano J;Femandez-Vivas M;Grau CT Gastric versus transpyloric feeding in severe traumatic brain injury:a prospective,randomized trial 2010

26.Dwolatzky T;Berezovski S;Friedmann R A prospective comparison of the use of nasogastric and percutaneous endoscopic gastrostomy tubes for long-term enteral feeding in older people[外文期刊] 2001(6)

27.Metheny NA;Clouse RE;Chang YH Tracheobronchial aspiration of gastric contents in critically ill tube-fed patients:frequency,outcomes,and risk factors[外文期刊] 2006

28.Bankhead R;Boullata J;Brantley S Enteral nutrition practice recommendations[外文期刊] 2009

29.Shang E;Geiger N;Sturm JW Pump-assisted enteral nutrition can prevent aspiration in bedridden percutaneous endoscopic gastrostomy patients[外文期刊] 2004(3)

30.Adams HP;Del ZG;Alberts MJ Guidelines for the early management of adults with ischemic stroke[外文期刊] 2007(5)

31.European Stroke Organisation(ESO)Executive Committee;ESO Writing Committee Guidelines for management of ischaemic stroke and transient ischaemic attack 2008 2008

32.Griesdale DE;de Souza RJ;van Dam RM Intensive insulin therapy and mortality among critically ill patients:a meta-analysis including NICE-SUGAR study data[外文期刊] 2009(8)

33.Moghissi ES;Korytkowski MT;Dinardo M American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control[外文期刊] 2009(6)

34.Amarenco P;Bogousslavsky J;Callahan AR High-dose atorvastatin after stroke or transient ischemic attack[外文期刊] 2006(6)

35.洪忠新;华鑫;武力对住院患者低胆固醇血症的调查与分析[期刊论文]-中国临床营养杂志 2008(1)

36.Vincent JL;Dubois MJ;Navickis RJ Hypoalbuminemia in acute illness:is there a rationale for intervention? A meta-analysis of cohort studies and controlled trials[外文期刊] 2003

37.Dubois MJ;Orellana-Jimenez C;Melot C Albumin administration improves organ function in critically ill hypoalbuminemic patients:a prospective,randomized,controlled,pilot study[外文期刊] 2006(10)

38.宿英英;高淑凤;车林海急性脑损伤并发低白蛋白血症的危险因素[期刊论文]-中国危重病急救医学 2000(5)

39.Guenter PA;Settle RG;Perlmutter S Tube feeding-related diarrhea in acutely ill patients 1991

40.Booth CM;Heyland DK;Paterson WG Gastrointestinal promotility drugs in the critical care setting:a systematic review of the evidence[外文期刊] 2002(7)

41.Martino R;Foley N;Bhogal S Dysphagia after stroke:incidence,diagnosis,and pulmonary complications[外文期刊] 2005

引证文献(7条)

1.张素杰.薛蓉.田德财.胡晨.翟飞.程焱神经内科老年住院患者营养状况评价及其与并发症的关系研究[期刊论文]-中国全科医学2013(14)

2.彭明强.林兴建.夏成才.胡守玮.陈道文早期肠内营养支持治疗对脑干梗死病人营养指标和预后的影响[期刊论文]-肠外与肠内营养 2013(4)

3.陈维生.张一臣.胡北.孙诚.吕波.叶珩.解迪.陈纯波促胃动力药在神经重症患者螺旋型鼻肠管置管中的应用[期刊论文]-实用医学杂志 2013(20)

4.金林梅.孙莉.高岚.曹杰神经危重症患者发生胃潴留相关危险因素及营养支持对预后的影响[期刊论文]-中风与神经疾病杂志2013(9)

5.陈晓艳.仲悦萍重型颅脑损伤患者鼻饲并发症的观察及护理[期刊论文]-实用临床医药杂志 2013(10)

6.宿英英.黄旭升.潘速跃.江文.杨弋.高亮.彭斌神经疾病并发医院获得性肺炎诊治共识[期刊论文]-中华神经科杂志 2012(10)

7.王丽娟.程云鼻饲患者胃潴留研究进展[期刊论文]-护理学杂志 2013(10)

引用本文格式:中华医学会肠外肠内营养学分会神经疾病营养支持学组神经系统疾病肠内营养支持操作规范共识(2011版)[期刊论文]-中华神经科杂志 2011(11)

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