2023 年《ESPEN 指南：共病住院患者营养支持》解读
Interpretation of the 2023 ESPEN Guideline on Nutritional Support for Polymorbid Medical Inpatients
由于我国老龄化趋势加快和居民生活行为方式的转变，致使慢性病共病成为公众健康一大挑战。共病现象使患者病情更加复杂、营养状况不佳，给患者健康和社会造成沉重负担。2018 年，欧洲临床营养和代谢学会（ESPEN）发布了《共病住院患者营养支持》，从共病住院患者的营养筛查、评估、需求、监测和干预等方面提供了 22 项建议和 4 项声明。其基于不断更新的研究证据，2023 年 6 月 ESPEN 指南工作组对 2018 版指南进行了更新，即 2023 年《ESPEN指南：共病住院患者营养支持》，为共病住院患者提供了基于最新循证证据的营养支持建议。本文对该指南进行解读，并就营养筛查和评估、口服营养补充、肠内营养和肠外营养、能量需求量的估算、蛋白质目标量、微量营养素的补充、特定疾病的营养补充、早期营养支持、出院后营养支持、身体功能检测、能量和蛋白质达标量、营养支持的组织管理、基础疾病对营养支持的影响、药物或营养素相互作用、营养生物标志物共 15 方面内容进行重点分析，旨在为我国临床共病住院患者营养管理实践提供指导。
ue to the accelerating trend of aging and transformation of residents'?lifestyles and behaviors in Chinamultiple chronic conditions have become a major public health challenge. The phenomenon of comorbidities complicates patients' conditions and poor nutritional statuscausing a heavy burden on patients' health and society. In 2018the European Society for Clinical Nutrition and MetabolismESPENpublished the ESPEN guidelines on nutritional support for polymorbid internal medicine patientswhich provides 22 recommendations and four statements on nutritional screeningassessment requirementsmonitoring and procedure of intervention for polymorbid medical inpatients. Based on continuously updated research evidencethe 2018 version of the guideline was updated by the ESPEN guideline Working Group in June 2023ESPEN guideline on nutritional support for polymorbid medical inpatientsto provide evidence-based recommendations on nutritional support for the polymorbid patient population hospitalized in medical wards. This article interprets and focuses 15 key points of the guidelineinclude nutritional screening and assessmentoral nutritional supplementsenteral nutrition and parenteral nutritionestimation of energy requirementsprotein targetsmicronutrients supplementationdisease-specific nutritional supplementationearly nutritional supportpost-discharge nutritional supportmonitoring of physical functionsenergy and protein requirementsorganizational changes in nutritional supportimpact of underlying diseases on nutritional supportdrugnutrient interactions and nutritional biomarkers. In order to provide guidance for nutritional management of polymorbid patients inChina.
吴太琴、甘秀妮、张欢、高燕、阳莉
10.12114/j.issn.1007-9572.2023.0824
临床医学内科学
慢性病共病共病共病现象营养支持管理指南解读
吴太琴,甘秀妮,张欢,高燕,阳莉.2023 年《ESPEN 指南：共病住院患者营养支持》解读[EB/OL].(2024-01-12)[2025-08-03].https://chinaxiv.org/abs/202401.00193.点此复制
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