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中华普通外科学文献(电子版) ›› 2025, Vol. 19 ›› Issue (02) : 73 -84. doi: 10.3877/cma.j.issn.1674-0793.2025.02.001

专家共识

肠外营养中电解质补充中国专家共识(2024版)
中国医疗保健国际交流促进会临床营养健康学分会, 中华医学会肠外肠内营养学分会, 中国营养学会临床营养分会, 中国医师协会营养医师专业委员会   
  • 收稿日期:2025-03-20 出版日期:2025-04-01
  • 基金资助:
    国家自然科学基金项目(72074222)中央高水平医院临床科研业务费项目(2022-PUMCH-B-054)四川省重点研发计划项目(2021YFS0378)

Chinese expert consensus on the application of electrolytes in parenteral nutrition (2024 edition)

International Exchange and Promotive Association for Medical and China, Society of Parenteral and Enteral Nutrition Chinese, Nutrition Society Branch of Clinical Nutrition Chinese, Medical Doctor Association Nutritionist Professional Committee Chinese   

  • Received:2025-03-20 Published:2025-04-01
引用本文:

中国医疗保健国际交流促进会临床营养健康学分会, 中华医学会肠外肠内营养学分会, 中国营养学会临床营养分会, 中国医师协会营养医师专业委员会. 肠外营养中电解质补充中国专家共识(2024版)[J/OL]. 中华普通外科学文献(电子版), 2025, 19(02): 73-84.

International Exchange and Promotive Association for Medical and China, Society of Parenteral and Enteral Nutrition Chinese, Nutrition Society Branch of Clinical Nutrition Chinese, Medical Doctor Association Nutritionist Professional Committee Chinese. Chinese expert consensus on the application of electrolytes in parenteral nutrition (2024 edition)[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2025, 19(02): 73-84.

电解质作为人体必需的营养素,在营养及代谢支持治疗中占据核心地位。为进一步规范肠外营养中电解质制剂的使用,中国医疗保健国际交流促进会临床营养健康学分会、中国医师协会营养医师专业委员会、中华医学会肠外肠内营养学分会以及中国营养学会临床营养分会,特邀国内重症医学、急诊医学、内科、外科及药学领域的权威专家,依据国内外最新指南、循证医学证据,并结合我国实际临床医疗环境,共同编纂该共识。本共识围绕以下主题进行阐述:肠外营养期间电解质监测、再喂养综合征的风险评估及营养治疗、各类疾病(包括重症、心力衰竭、术后短肠综合征、围手术期、创伤、糖尿病足、肾脏病、肝病、新生儿)肠外营养期间的电解质补充及肠外营养中电解质制剂的配伍原则,最终提出13个问题、26条推荐意见,旨在为肠外营养中电解质的合理应用提供科学、规范、实用的指导。

As essential nutrients for human beings, electrolytes play a central role in nutritional and metabolic support treatment. To further standardize the use of electrolyte preparations in parenteral nutrition, China International Exchange and Promotive Association for Medical and Health Care Clinical Nutrition Health Branch, Chinese Medical Doctor Association Nutritionist Professional Committee, Chinese Society of Parenteral and Enteral Nutrition, and Chinese Nutrition Society Branch of Clinical Nutrition,invited authoritative experts in the fields of critical medicine, emergency medicine, internal medicine,surgery, and pharmacology in China to create this expert consensus. This consensus was based on the latest guidelines and evidence-based medicine at home and abroad, and combined with the actual clinical medical environment in China. This consensus covered the following topics: electrolytes monitoring during parenteral nutrition, risk assessment and nutritional treatment of refeeding syndrome, electrolytes supplementation during parenteral nutrition for various diseases (including severe diseases, heart failure, post-surgical short bowel syndrome, perioperative period, trauma, diabetic foot, chronic kidney disease, liver disease, neonates),and the compatibility principles of electrolyte preparations in parenteral nutrition. Finally, 13 clinical questions and 26 recommendations were proposed aiming at providing scientific, standardized, and practical guidance for the rational application of electrolytes in parenteral nutrition.

表1 证据推荐分级的评估、制定与评价(GRADE)证据质量分级
表2 鉴别成年患者再喂养综合征(RFS)不同发生风险的美国肠外肠内营养学会(ASPEN)共识
表3 新生儿肠外营养(PN)治疗中电解质的推荐量(mmol·kg-1·d-1
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