危重症患者早期肠内营养供给量的研究进展

对危重症患者而言，早期启用肠内营养（EN）不仅是补充营养，更重要的是发挥其在维持肠道功能和肠道微生态中的特殊重要作用。任何药物治疗产生的效果都与剂量相关，营养治疗亦是如此。理想的EN目标在于供给的量与质能够带给危重症患者最大获益与最小伤害，而充分营养供给并避免医源性营养不良是最终的理想目标。但是，早期EN的不耐受是危重症患者常面临的困难与挑战，不恰当的供给将会产生不良影响，甚至危害。认识这些可能的风险并予以规避是ICU医护人员需要重视与了解的必要知识。在一些严重的或特殊疾病状态下，及时评估及调整EN治疗方案才可能实现其理想目标，使患者最大获益。

Dosages of early enteral nutrition in critically ill patients

For critically ill patients, enteral nutrition at early phase can not only provide nutrition but also maintain the function and microecology of intestine. The therapeutic effects of medicines depend on their dosages, and so does nutrition therapy. Ideally, the quantity and quality of enteral nutrition make maximum benefit and minimum damage in critically ill patients, with the ultimate goal of sufficient nutrition therapy and no iatrogenic malnutrition. Intolerance of early enteral nutrition is a common problem, and challenge for critically ill patients. Improper nutrition therapy will have adverse and even harmful effects, which should be well learned by doctors and nurses of intensive care unit. In serious or some special medical situations, regimen of nutrition should be evaluated and adjusted timely to achieve the ideal goal and make maximumbenefit for patients.