1995肠内营养的使用指南（英文）AGA.docVIP

AMERICAN GASTROENTEROLOGICAL ASSOCIATION American Gastroenterological Association Medical Position Statement: Guidelines for the Use of Enteral Nutrition This document presents the official recommendations of the American Gastroenterological Association (AGA) on the use of enteral nutrition. It was approved by the AGA Patient Care Committee on September 17, 1994, and by the AGA Governing Board on November 11, 1994. The need to avoid prolonged starvation in patients is well recognized. More recently, it has been realized that without intraluminal fuels, intestinal integrity may deteriorate and allow translocation of gut bacteria. One means to combat nutrient deprivation and simultaneously to keep the local defense barrier of the intestine intact is tube feeding, i.e., enteral nutrition. This technique has been practiced in varying forms for hundreds of years. Today, technical innovations have made it a more acceptable procedure to patients and a less costly alternative to parenteral nutrition. It is important for physicians to understand the indications for enteral nutrition, its contraindications, its risks, sites for nutrient delivery, and alternative tube placement techniques. This document provides gastroenterologists with recommendations for providing safe and effective enteral nutrition to adult patients. It is based on the American Gastroenterological Association Technical Review on Tube Feeding for Enteral Nutrition,1 which should be consulted for additional information. Indications for Tube Feeding Tube feeding should be considered for patients who cannot or will not eat, for patients who have a functional gut, and for whom a safe method of access is possible. 1.?In most patients, nutrition support should be initiated after 1-2 weeks without nutrient intake. Enteral feeding is preferable to parenteral therapy provided there are no contraindications, access can be attained safely, and oral intake is not possible. In some patients, combinations of enteral