Heymsfield S B, Bethel R A, Ansley J D, Nixon D W, Rudman D
Ann Intern Med. 1979 Jan;90(1):63-71. doi: 10.7326/0003-4819-90-1-63.
Severe protein-energy undernutrition is a frequent finding among chronically ill patients. Its causes are anorexia, hypermetabolism, and malabsorption. Adverse consequences include impaired cell-mediated immunity increased susceptibility to infection, poor wound healing, weakness, and death. Spontaneous oral intake is inadequate in patients with this disorder, and therapeutic maintenance or repletion alimentation is needed. Enteral hyperalimentation is the method of choice, if tolerated. A successful treatment program usually requires a small-bore, flexible nasoenteral tube, appropriate feeding solution, and constant flow delivery of nutrient. If only partial dietary requirements are tolerated enterally, peripheral intravenous nutrient solutions can often supply the deficit. Although not suitable for all patients, enteral hyperalimentation is more physiologic, safer, easier, and more economical than central venous hyperalimentation. It would be well tolerated by many patients who now receive nutritional repletion by the latter method.
严重的蛋白质 - 能量营养不良在慢性病患者中很常见。其病因包括厌食、高代谢和吸收不良。不良后果包括细胞介导免疫受损、感染易感性增加、伤口愈合不良、虚弱和死亡。患有这种疾病的患者自主经口摄入量不足，需要进行治疗性维持或补充营养。如果耐受，肠内高营养是首选方法。成功的治疗方案通常需要一根细孔径、可弯曲的鼻肠管、合适的喂养溶液以及持续输注营养液。如果仅能部分耐受肠道内的饮食需求，外周静脉营养溶液通常可以补充不足部分。尽管肠内高营养并不适用于所有患者，但它比中心静脉高营养更符合生理、更安全、更简便且更经济。许多目前通过后一种方法接受营养补充的患者对肠内高营养的耐受性会很好。
