\u4e3a\u4e86\u89c4\u8303\u80a0\u5185\u8425\u517b\u8f93\u6ce8\u7684\u6d41\u7a0b\uff0c\u67e5\u627e\u4e86\u4e34\u5e8a\u80a0\u5185\u8425\u517b\u8f93\u6ce8\u8fc7\u7a0b\u4e2d\u5e38\u7528\u7684\u8bc4\u4f30\u91cf\u8868\uff0c\u7ed9\u4e34\u5e8a\u5f00\u5c55\u8425\u517b\u652f\u6301\u53ca\u6cbb\u7597\u5de5\u4f5c\u63d0\u4f9b\u53c2\u8003\u3002<\/p>\n
\u4e66\u7c4d\u5e7f\u544a01<\/p>\n
\u8425\u517b\u98ce\u9669\u7b5b\u67e5 2002\uff08NRS 2002\uff09<\/p>\n
\u8425\u517b\u7684\u8bc4\u4f30\u548c\u7b5b\u67e5\uff0cNRS 2002\u6709\u5faa\u8bc1\u533b\u5b66\u57fa\u7840\uff0c\u591a\u9879\u7814\u7a76\u7ed3\u679c\u663e\u793a\u5b58\u5728\u8425\u517b\u98ce\u9669\u7684\u60a3\u8005\u884c\u8425\u517b\u652f\u6301\u6cbb\u7597\u66f4\u6709\u6548\uff08\u80fd\u591f\u6539\u5584\u4e34\u5e8a\u7ed3\u5c40\uff09\uff1b\u800c\u5bf9\u4e8e\u65e0\u8425\u517b\u98ce\u9669\u7684\u60a3\u8005\uff0c\u5176\u7597\u6548\u4e0d\u660e\u663e\u3002\u81ea2005\u5e74\u8d77CSPEN\u5e94\u7528NRS 2002\u5728\u4e2d\u56fd\u7ec4\u7ec7\u7684\u591a\u9879\u524d\u77bb\u6027\u7814\u7a76\u5747\u8bc1\u5b9e\u7ed9\u4e88\u5b58\u5728\u8425\u517b\u98ce\u9669\uff08NRS 2002\u22653\u5206\uff09\u7684\u60a3\u8005\u8425\u517b\u652f\u6301\u6cbb\u7597\uff0c\u53ef\u6539\u5584\u5176\u4e34\u5e8a\u7ed3\u5c40\u6307\u6807\u3002\u56e0\u5176\u8bc6\u522b\u8425\u517b\u98ce\u9669\u7684\u654f\u611f\u6027\u548c\u7279\u5f02\u6027\u5747\u8f83\u9ad8\uff0c\u56fd\u5185\u5916\u591a\u4e2a\u8425\u517b\u6307\u5357\u6216\u5171\u8bc6\u5747\u63a8\u8350NRS 2002 \u505a\u4e3a\u4f4f\u9662\u60a3\u8005\u9996\u9009\u7684\u8425\u517b\u7b5b\u67e5\u5de5\u5177\u3002<\/p>\n<\/p>\n
02<\/p>\n
\u5fae\u578b\u8425\u517b\u8bc4\u5b9a\u6cd5\u7b80\u8868\uff08MNA\u2011SF\uff09<\/p>\n
MNA-SF\u7528\u4e8e\u8bc6\u522b\u8425\u517b\u4e0d\u826f\u6216\u5df2\u53ef\u80fd\u53d1\u751f\u8425\u517b\u4e0d\u826f\u7684\u4eba\u7fa4\u3002\u57fa\u4e8e\u5927\u6837\u672c\u4eba\u7fa4\u7814\u7a76\u7684\u7cfb\u7edf\u8bc4\u4ef7\u663e\u793a\uff0c\u8be5\u7b5b\u67e5\u5de5\u5177\u5bf9\u4e8e\u8bc6\u522b\u8425\u517b\u4e0d\u826f\u5177\u6709\u826f\u597d\u7684\u4ef7\u503c\uff0c\u5c24\u4ee5\u8001\u5e74\u4eba\u7fa4\u4e3a\u8457\uff0c\u5f53\u4f53\u91cd\u53ca\u4f53\u8d28\u6307\u6570\uff08BMI\uff09\u65e0\u6cd5\u6d4b\u91cf\u65f6\uff0c\u53ef\u7528\u5c0f\u817f\u56f4\u66ff\u4ee3\u30022011\u5e74ASPEN\u628aMNA-SF\u7eb3\u5165\u6210\u4eba\u60a3\u8005\u8425\u517b\u7b5b\u67e5\u7684\u63a8\u8350\u5de5\u5177\u3002CSPEN\u7684\u8001\u5e74\u8425\u517b\u6307\u5357\u5efa\u8bae\u5c06MNA-SF\u7528\u4e8e\u4f4f\u9662\u3001\u793e\u533a\u5c45\u5bb6\u53ca\u517b\u8001\u673a\u6784\u7684\u8001\u5e74\u60a3\u8005\uff0c\u4e3a\u5f00\u5c55\u89c4\u8303\u5316\u8425\u517b\u652f\u6301\u6cbb\u7597\u63d0\u4f9b\u4f9d\u636e\u3002<\/p>\n<\/p>\n
03<\/p>\n
\u8425\u517b\u4e0d\u826f\u901a\u7528\u7b5b\u67e5\u5de5\u5177\uff08MUST\uff09<\/p>\n
MUST\u662f\u82f1\u56fd\u80a0\u5916\u80a0\u5185\u8425\u517b\u5b66\u4f1a\uff08BAPEN\uff09\u8425\u517b\u4e0d\u826f\u54a8\u8be2\u7ec4\u5236\u8ba2\u7684\uff0c\u5e94\u7528\u8303\u56f4\u5305\u62ec\u533b\u9662\u75c5\u623f\u3001\u95e8\u8bca\u3001\u793e\u533a\u53ca\u5176\u4ed6\u7167\u62a4\u673a\u6784\u7684\u6210\u4eba\u60a3\u8005\u30022017\u5e74ESPEN\u5728\u8425\u517b\u4e0d\u826f\u672f\u8bed\u7684\u5b9a\u4e49\u6307\u5357\u4e2d\uff0c\u5efa\u8bae\u5c06MUST\u548cNRS 2002\u540c\u7528\u4e8e\u6210\u4eba\u60a3\u8005\u7684\u8425\u517b\u98ce\u9669\u7b5b\u548c\u67e5\u4e2d\u3002<\/p>\n<\/p>\n
04<\/p>\n
\u5371\u91cd\u75c7\u8425\u517b\u98ce\u9669\u8bc4\u5206\uff08NUTRIC\uff09<\/p>\n
NUTRIC\u8bc4\u5206\u53ef\u5e94\u7528\u4e8e\u91cd\u75c7\u60a3\u8005\uff0c\u662f\u57fa\u4e8e\u5e74\u9f84\u548c\u75be\u75c5\u4e25\u91cd\u7a0b\u5ea6\uff3b\u901a\u8fc7\u6025\u6027\u751f\u7406\u4e0e\u6162\u6027\u5065\u5eb7\u8bc4\u5206\u2161\uff08acute physiology and chronic health evaluation \u2161\uff0cAPACHE\u2161\uff09\u548c\u5e8f\u8d2f\u5668\u5b98\u8870\u7aed\uff08sequential organ failure assessment\uff0cSOFA\uff09\u8bc4\u5206\u3001\u5171\u75c5\u60c5\u51b5\u3001\u4f4f\u9662\u81f3ICU\u5929\u6570\uff0c\u4ee5\u53ca\u5305\u62ec\u6216\u4e0d\u5305\u62ec\u4ee5IL-6\u6c34\u5e73\u6765\u8bc4\u4f30\u708e\u75c7\u53cd\u5e94\uff3d\u7684\u65b0\u7684\u98ce\u9669\u8bc4\u4f30\u5de5\u5177\u3002\u8be5\u8bc4\u5206\u7684\u9884\u671f\u4f18\u52bf\u662f\u80fd\u591f\u663e\u793a\u8bc4\u5206\u4e0e\u8425\u517b\u5e72\u9884\u4e4b\u95f4\u5173\u4e8e\u7ed3\u679c\u7684\u76f8\u4e92\u4f5c\u7528\uff0c\u7f3a\u70b9\u662f\u4e0d\u5305\u62ec\u8425\u517b\u53c2\u6570\u3002<\/p>\n<\/p>\n
05<\/p>\n
\u683c\u62c9\u65af\u54e5\u660f\u8ff7(GCS\uff09\u8bc4\u5206<\/p>\n
\u683c\u62c9\u65af\u54e5\u660f\u8ff7\u8bc4\u5206\u6cd5\uff08GCS,Glasgow Coma Scale\uff09\u662f\u8bc4\u4f30\u75c5\u4eba\u660f\u8ff7\u7a0b\u5ea6\u7684\u65b9\u6cd5\uff0c\u662f\u7531\u82f1\u56fd\u683c\u62c9\u65af\u54e5\u5927\u5b66\u7684\u4e24\u4f4d\u795e\u7ecf\u5916\u79d1\u6559\u6388Graham Teasdale\u4e0eBryan J.Jennett\u57281974\u5e74\u53d1\u660e\u7684\u6d4b\u8bc4\u660f\u8ff7\u7684\u65b9\u6cd5\u3002\u5206\u522b\u4ece\u7741\u773c\u53cd\u5e94\uff084\u5206\uff09\u3001\u8a00\u8bed\u53cd\u5e94\uff085\u5206\uff09\u3001\u8fd0\u52a8\u53cd\u5e94\uff086\u5206\uff09\u8fdb\u884c\u8bc4\u4f30\uff0cGCS\u7ed3\u679c\u8bc4\u4ef7\u6b63\u5e38\u4eba\uff1a15\u5206\uff0c\u8f7b\u5ea6\u610f\u8bc6\u969c\u788d\uff1a12\u5206\u523014\u5206\uff0c\u4e2d\u5ea6\u610f\u8bc6\u969c\u788d\uff1a9\u5206\u523011\u5206\uff0c\u660f\u8ff7\uff1a3\u5206\u52308\u5206\u3002<\/p>\n<\/p>\n
06<\/p>\n
\u6025\u6027\u80c3\u80a0\u635f\u4f24\uff08AGI\uff09\u8bc4\u4f30\u91cf\u8868\u53caAGIUS\u8bc4\u5206<\/p>\n
\u6839\u636e2012\u5e74\u6b27\u6d32\u91cd\u75c7\u533b\u5b66\u534f\u4f1a\u8179\u90e8\u75be\u75c5\u5de5\u4f5c\u7ec4\uff08ESICM-WGAP\uff09\u5236\u5b9a\u548c\u9881\u5e03\u7684\u300a\u6025\u6027\u80c3\u80a0\u635f\u4f24\u7684\u5b9a\u4e49\u4e0e\u5206\u7ea7\u8bca\u7597\u5efa\u8bae\u300b\uff0c\u76ee\u524d\u6025\u6027\u80c3\u80a0\u635f\u4f24\uff08acute gastrointestinal injury\uff0cAGI\uff09\u5b9a\u4e49\u4e3a\u7531\u4e8e\u91cd\u75c7\u75c5\u4eba\u6025\u6027\u75be\u75c5\u672c\u8eab\u5bfc\u81f4\u7684\u80c3\u80a0\u529f\u80fd\u969c\u788d\uff0c\u6839\u636e\u4e25\u91cd\u6027\u8fdb\u884c\u5206\u7ea7\u3002\u5728\u80c3\u80a0\u529f\u80fd\u969c\u788d\u9886\u57df\u4e2d\uff0c\u6709\u7814\u7a76\u8005\u8bbe\u8ba1\u8bc4\u5206\u7cfb\u7edf\u63a2\u7d22\u5176\u5728\u8bc4\u4f30\u91cd\u75c7\u75c5\u4eba\u80c3\u80a0\u529f\u80fd\u635f\u4f24\u60c5\u51b5\u53ca\u9884\u6d4b\u5582\u517b\u4e0d\u8010\u53d7\u7b49\u65b9\u9762\u7684\u4f5c\u7528\uff0c\u5982\u6025\u6027\u80c3\u80a0\u635f\u4f24\u8d85\u58f0\uff08acute gastrointestinal injury ultrasonography\uff0cAGIUS\uff09\u68c0\u67e5\u8bc4\u5206\uff0c\u53ef\u7528\u4e8e\u8bc4\u4f30\u91cd\u75c7\u75c5\u4eba\u80c3\u80a0\u529f\u80fd\u635f\u4f24\u60c5\u51b5\u53ca\u9884\u6d4b\u5582\u517b\u4e0d\u8010\u53d7\u3002<\/p>\n<\/p>\n
07<\/p>\n
\u8bef\u5438\u98ce\u9669\u8bc4\u4f30\u91cf\u8868<\/p>\n
\u4e2d\u56fd\u795e\u7ecf\u5916\u79d1\u91cd\u75c7\u60a3\u8005\u8425\u517b\u6cbb\u7597\u4e13\u5bb6\u5171\u8bc6\uff082022\u7248\uff09\u6307\u51fa\u8bef\u5438\u7684\u98ce\u9669\u56e0\u7d20\u6709\uff1a\u9ad8\u9f84\uff08\uff1e70 \u5c81\uff09\u3001\u9f3b\u80c3\u7ba1\u80a0\u5185\u8425\u517b\u5582\u517b\u3001\u673a\u68b0\u901a\u6c14\u3001\u541e\u54bd\u529f\u80fd\u969c\u788d\u3001\u610f\u8bc6\u4e27\u5931\/\u4e0b\u964d\u3001\u58f0\u95e8\u6216\u8d32\u95e8\u5173\u95ed\u529f\u80fd\u4e0d\u5168\u3001\u5408\u5e76\u795e\u7ecf\u7cfb\u7edf\u6216\u7cbe\u795e\u7c7b\u75be\u75c5\u3001\u4f7f\u7528\u9547\u9759\u6216\u808c\u677e\u836f\u7269\u3001\u9662\u5185\u5916\u8f6c\u8fd0\u7b49\u3002\u4e2d\u56fd\u5371\u91cd\u75c7\u60a3\u8005\u80a0\u5185\u8425\u517b\u652f\u6301\u5e38\u89c1\u5e76\u53d1\u75c7\u9884\u9632\u7ba1\u7406\u4e13\u5bb6\u5171\u8bc6\uff082021\u7248\uff09\u4e5f\u6307\u51fa\u4e86\u9ad8\u8bef\u5438\u98ce\u9669\u7684\u56e0\u7d20\u3002\u6b63\u662f\u57fa\u4e8e\u6b64\uff0c\u4e34\u5e8a\u603b\u7ed3\u51fa\u4e86\u7b80\u6613\u7684\u8bc4\u4f30\u65b9\u6cd5\uff0c\u9ec4\u91d1\u4e03\u6761\uff1a\u673a\u68b0\u901a\u6c14\u3001\u4ef0\u5367\u4f4d\u3001\u610f\u8bc6\u6c34\u5e73\u4e0b\u964d\u3001\u795e\u7ecf\u529f\u80fd\u7f3a\u635f\u3001\u80c3\u98df\u7ba1\u8fd4\u6d41\u3001\u5e74\u9f84>65\u5c81\u3001\u533b\u62a4\u60a3\u6bd4\u4f8b\u4e0d\u8db3\u3002\u5982\u5176\u4e2d\u5927\u4e8e\u7b49\u4e8e3\u6761\uff0c\u63d0\u793a\u8bef\u5438\u98ce\u9669\u5f88\u9ad8\uff0c\u5efa\u8bae\u91c7\u7528\u5e7d\u95e8\u540e\u5582\u517b\u3002<\/p>\n
\u8bef\u5438\u8bc4\u4f30\u91cf\u8868\u8bc4\u4ef7\u6807\u51c6\uff1a10-12\u5206\u4e3a\u4f4e\u5ea6\u5371\u9669\uff1b13-18\u5206\u4e3a\u4e2d\u5ea6\u5371\u9669\uff1b19-23\u5206\u4e3a\u91cd\u5ea6\u5371\u9669\u3002<\/p>\n
\u8bc4\u4f30\u8981\u6c42\uff1a\u5165\u9662\uff08\u8f6c\u5165\uff09\u3001\u624b\u672f\uff08\u4ecb\u5165\uff09\u3001\u75c5\u60c5\u53d8\u5316\uff08\u62a4\u7406\u7ea7\u522b\u66f4\u6539\u4e3a\u4e0a\u4e00\u7ea7\u3001\u533b\u5631\u53d8\u66f4\u996e\u98df\uff09\u65f6\uff1b\u8bc4\u520610-18\u5206\uff08\u4f4e\u4e2d\u5ea6\u5371\u9669\uff09\uff0c\u6bcf\u5468\u8bc4\u4f301\u6b21\u8bef\u5438\u98ce\u9669\uff1b\u8bc4\u5206\u226519\u5206\uff08\u91cd\u5ea6\u5371\u9669\uff09\uff0c\u6bcf\u65e5\u8bc4\u4f301\u6b21\u8bef\u5438\u98ce\u9669\u3002<\/p>\n<\/p>\n
\u4e66\u7c4d\u5e7f\u544a<\/p>\n
08<\/p>\n
\u6d3c\u7530\u996e\u6c34\u8bd5\u9a8c<\/p>\n
\u65e5\u672c\u5b66\u8005\u6d3c\u7530\u4fca\u592b\u63d0\u51fa\uff0c\u5206\u7ea7\u660e\u786e\u6e05\u695a\uff0c\u64cd\u4f5c\u7b80\u5355\uff0c\u5229\u4e8e\u9009\u62e9\u6709\u6cbb\u7597\u9002\u5e94\u75c7\u7684\u60a3\u8005\uff0c\u8981\u6c42\u60a3\u8005\u610f\u8bc6\u6e05\u695a\u5e76\u80fd\u591f\u6309\u7167\u6307\u4ee4\u5b8c\u6210\u8bd5\u9a8c\u3002GCS\u8bc4\u520612\u5206\u4ee5\u4e0a\u9002\u7528\u3002\u65e0\u9700\u544a\u8bc9\u60a3\u8005\u6b63\u5728\u8fdb\u884c\u6d4b\u8bd5\uff0c\u4ee5\u514d\u5f15\u8d77\u7d27\u5f20\u3002<\/p>\n
\u8bc4\u5b9a\u6b63\u5e38\uff1a1\u7ea7\uff0c5\u79d2\u4e4b\u5185\uff1b\u53ef\u7591\uff1a5\u79d2\u4ee5\u4e0a\u62162\u7ea7\uff1b\u5f02\u5e38\uff1a3-5\u7ea7<\/p>\n<\/p>\n
09<\/p>\n
\u80a0\u5185\u8425\u517b\u8010\u53d7\u6027\u8bc4\u4f30\u91cf\u8868<\/p>\n
\u4e1c\u90e8\u6218\u533a\u603b\u533b\u9662\u4e8e 2018 \u5e74\u5f00\u5c55\u4e00\u9879\u5173\u4e8e\u5582\u517b\u6d41\u7a0b\u7684\u591a\u4e2d\u5fc3\u6574\u7fa4\u968f\u673a\u5bf9\u7167\u7814\u7a76\uff08randomized controlled trial\uff0cRCT\uff09\uff0c\u5236\u8ba2\u4e86\u57fa\u4e8e\u80c3\u80a0\u9053\u75c7\u72b6\u7684\u5582\u517b\u4e0d\u8010\u53d7\u8bc4\u5206\u8f85\u52a9\u80a0\u5185\u8425\u517b\u7684\u5b9e\u65bd\u3002\u5728\u8fdb\u884c\u80a0\u5185\u8425\u517b\u8fc7\u7a0b\u4e2d\u51fa\u73b0\u5582\u517b\u4e0d\u8010\u53d7\u65f6\uff0c\u9700\u8981\u6bcf6-8\u5c0f\u65f6\u8bc4\u4f301\u6b21\u60a3\u8005\u7684\u80a0\u5185\u8425\u517b\u8010\u53d7\u6027\u8bc4\u5206\u8868\uff0c\u6839\u636e\u8bc4\u5206\u7ed3\u679c\u8fdb\u884c\u80a0\u5185\u8425\u517b\u8f93\u6ce8\u8c03\u6574\uff1a\uff081\uff09\u8bc4\u5206\u589e\u52a0\u4e3a\u22641\u5206\uff1a\u7ee7\u7eed\u80a0\u5185\u8425\u517b\uff0c\u589e\u52a0\u901f\u5ea6\uff1b\uff082\uff09\u8bc4\u5206\u589e\u52a02-3\u5206\uff1a\u7ee7\u7eed\u80a0\u5185\u8425\u517b\uff0c\u7ef4\u6301\u539f\u901f\u5ea6\u6216\u51cf\u6162\u901f\u5ea6\uff0c\u5bf9\u75c7\u6cbb\u7597\uff1b\uff083\uff09\u8bc4\u5206\u589e\u52a0\u22654\u5206\u6216\u603b\u5206\u22655\u5206\uff1a\u6682\u505c\u80a0\u5185\u8425\u517b\uff0c\u5e76\u505a\u76f8\u5e94\u5904\u7406\u3002<\/p>\n<\/p>\n
10<\/p>\n
Hart\u8179\u6cfb\u8ba1\u5206\u6cd5<\/p>\n
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11<\/p>\n
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