危重症患者若消化系统无特殊异常，提倡在入住重症监护病房后 24~48 h开始实施肠内营养，但行肠内营养治疗 期间腹泻发生率较高，因肠内营养相关性腹泻所致营养成分丢失、水电解质酸碱平衡紊乱，甚至使患者被迫中断肠内营养，常 导致不良的临床结局，延长住院时间，增加病死率，其带给患者的痛苦和经济负担不容忽视。但目前关于危重症患者腹泻的流 行病学研究多来自国外，并不能完全反映我国实际情况；在国内仍缺乏统一的诊断和评估标准；肠内营养相关性腹泻是多种不 同因素的综合结果，危重症患者病情复杂，对其预防与治疗仍面临着较大的挑战。要保证危重症患者肠内营养治疗安全，医护 人员必须具备风险评估意识、动态监测患者危险因素、动态评估胃肠道功能，并制定个性化、合理化的营养方案，以最大限度减 少肠内营养相关性腹泻的发生。鉴于此，本文就近年来肠内营养相关性腹泻的定义、评估、相关因素、治疗和护理对策等方面 进行文献综述，为医护人员科学实施肠内营养，降低危重症患者肠内营养相关性腹泻发生率、提高喂养效果提供参考。

If there are no special abnormalities in the digestive system of critically ill patients, it is recommended to start enteral nutrition from 24 to 48 hours after admission to the ICU, but the incidence of diarrhea in critically ill patients during enteral nutrition is rather high, which caused loss of nutrients, disturbance of water⁃electrolyte acid⁃base balance, and even forced interruption of enteral nutrition.It often leads to adverse clinical outcomes, increasing the length of hospital stay and mortality.The pain and economic burden it brings to patients cannot be ignored.Currently, most of the epidemiological studies on diarrhea in critically ill patients come from abroad, which cannot fully reflect the actual situation in China; there is still lack of unified diagnostic and evaluation standards;EN diarrhea is a comprehensive result of many factors, the condition of critically ill patients is complex, and we are still facing great challenges in its prevention and treatment.To ensure the safety of enteral nutrition treatment, the medical staff must have the awareness of risk assessment, monitor the risk factors and assess gastrointestinal function dynamically, then formulate personalized and reasonable nutrition programs to minimize the incidence of EN diarrhea.Therefor, the article summarized the definition、assessment tools、risk factors、nursing and treatment strategies of enteral nutrition⁃related diarrhea in critically patients in recent years.Aiming to provide reference for medical staff to scientifically implement enteral nutrition，reduce the incidence of enteral nutrition⁃related diarrhea in critically ill patients, and improve the effect of feeding.