消化吸收障碍和应激所致的高分解代谢状态是引发患者营养不良的主要生理病理机制,营养治疗是危重患者救治 过程中必不可少的治疗手段之一。 肠内营养是营养治疗的首选通路,可显著降低感染性并发症发生率和死亡率,降低器官衰 竭发生率和手术干预率,控制患者血糖波动,从而改善患者预后。 其中,鼻胃管作为一种简便的床旁操作技术,医疗成本较 低,具有无创、简便、经济等优点,是开展短期(<4 周)肠内营养的首选方式。 然而,鼻胃管的不规范使用也会导致相关并发症 的发生,如鼻咽部刺激、溃疡、出血、导管脱出或堵塞、反流以及吸入性肺炎等。 本文主要从鼻胃管的适应证、促动力药的使 用、鼻胃管口径的选择和鼻胃管的定位等方面对《中国成年患者营养治疗通路指南》进行解读,为中国成年患者营养治疗过程 中鼻胃管的选择与合理应用提供最新的循证医学证据。

The main physiopathological mechanisms of malnutrition are disorder of digestion and absorption and stress-induced hypercatabolic state. Nutritional therapy is one of the essential treatments for critically ill patients. Enteral nutrition EN is the preferred route of nutritional support therapy. Proper EN significantly reduces infectious complications and better controls the blood glucose results in decreased organ failure and surgical intervention rate. EN may improve outcomes in these patients. Nasogastric tube as a simple bedside technique with low medical cost non-invasive simple and economical is the preferred way for short-term <4 weeks enteral nutrition. However improper use of nasogastric tubes can also lead to complications such as nasopharyngeal irritation ulcers bleeding catheter prolapse or blockage reflux and aspiration pneumonia. This article interpret the guideline on route of nutrition for Chinese adult patients covering the indications for nasogastric tube the use of prokinetic drugs the selection of nasogastric tube bore and the positioning of nasogastric tube are explained so as to provide the latest evidence-based medical evidence for the selection and rational application of nasogastric tube.