-共识、指南与标准％D0I：10.16689/ll-9349/r.2019.02.006复方氨基酸注射液临床应用专家共识1高纯,#李梦,2韦军民,3李玉珍,*田伟军，'姜海平,6沈威,$许爱国，8余震,9陈东生,10陈莲珍管文贤,12江华,13李大魁,13梅丹于吉人,$赵春临，1+范伟，16胡松康焰,13康维明，18吕传柱/刘东，19刘辉,9吕永宁,20孟翔凌,21宋金春,12孙明伟，22汤庆娅,23王烈，"王景杰,2+吴东方,26许媛,2$徐华,22颜伟慧，13闫雪莲,12曾俊,28张片红/龚建平,29郭增清「胡俊波,30孟庆华,31李增宁,32钱素云,33秦宝丽，3*沈生荣,3+田字彬,36许红霞/姚颖,3$于乐成,38石汉平；中华医学会肠外肠内营养学分会，中国抗癌协会肿瘤营养专业委员会C华中科技大学同济医学院附属同济医院，武汉430030；2北京医院/国家老年医学中心，北京100730；3北京大学人民医院，北京100044；*天津医科大学总医院，天津300052；5暨南大学附属第一医院，广州510630；6南昌大学第二附属医院，南昌330006；7郑州大学第一附属医院，郑州450052；8同济大学附属第十人民医院，上海200072；9华中科技大学同济医学院附属协和医院，武汉430022；10国家癌症中心/国家肿瘤临床医学中心/中国医学科学院北京协和医学院肿瘤医院，北京100029；"南京 大学医学院附属鼓楼医院，南京210008；12四川省医学科学院•四川省人民医院，成都610072；13北京协和医院，北京100730；14浙江大学医学院附属第一医院，杭州310003；15贵州省人民医院，贵阳550002；16武汉市第一医院，武汉430022；17四川大学华西医院，成都610041；18海南医学院，海口571199；19中国人民解放军中部战区总医院，武汉430070；20安徽医科大学第一附属医院，合肥230022；21武汉大学人民医院，武汉430060；22上海交通大学医学院附属新华医院，上海200092；23中国人民解放军联勤部第900医院，福州350025；24空军军医大学唐都医院，西安710038；25武汉大学中南医院，武汉430071；26北京清华长庚医院，北京102218；27武汉儿童医院，武汉430015；28浙江大学医学院附属第二医院，杭州310009；29福建省肿瘤医院/福建医科大学附属肿瘤医院，福州350014；30首都医科大学附属北京佑安医院，北京100069；31河北医科大学第一医院，石家庄050031；32首都医科大学附属北京儿童医院，北京100045；33辽宁省肿瘤医院，沈阳110042；34浙江大学公共卫生学院，杭州310058；35青岛大学附属医院，青岛266000；36陆军军医大学大坪医院，重庆400042；37东部战区总医院，南京中医药大学附属八一医院，南京210002；38首都医科大学附属北京世纪坛医院，北京100038)摘要：复方氨基酸注射液是肠外营养中氮的来源，广泛应用于不能经胃肠道给予或经胃肠道给予不能满足其营养需求的患者，在营养治疗中起重要作用。

但目前对于复方氨基酸注射液临床应用的指征、剂型、剂量、时机，国内并无系统的指南或共识。

为了进一步规范复方氨基酸注射液的临床应用，中华医学会肠外肠内营养学分会(Chinese Society for Parenteral and Enteral Nutrition,CSPEN)及中国抗癌协会肿瘤营养专业委员会(Chinese Society oO Nutritional Oncclogy,CSNO)组织全国专家，在系统性文献检索的基础上，参考美国肠外肠内营养学会(American Society for ParenteraO and EnteraO Nutrition,ASPEN)、欧洲临床营养和代谢学会(European Society for ClinicaO Nutrition and Metabolism,ESPEN)&CSPEN及CSNO指南，结合我国临床实践，经多次交流讨论,达成此共识。

包括10条推荐意见，涉及不同患者的蛋白质需要量及氨基酸剂型选择。

关键词：复方氨基酸注射液;肠外营养;蛋白质;营养治疗;专家共识Expert consensus on clinical use of compound amino acid injection!GAO Chun,1LI Meng,2WEI Jun-min,3LI Yu-zhen,)T!ANWei-jun)5JIANG Hai-ping,6SHENW—7XU Ai-guo,8YU Zhen,)CHEN Dong-sheng,10CHEN Lian-zhen,11GUAN Wen-xian,12JIANG Hua,11LI Da-Pu—11MEI Dan,14YU Ji-ren,7ZHAO CCun-lin,15FAN We-,16H U Song,17K ANG Yan,13KANG Wei-ming,18LV Chuan-zhu,1LI A Dong,19LIU Hui,9LV Yong-ring,22M ENG Xiang-Png, 21SONG Jin-chun,12SUN Ming-pei,227：NG Qing-pa,23W4NG Lie,22W4NG Jing-pe,22WU Dong-pang,22XU Yuan,22XU Hua,22Y4N Wei-Pu—13YAN Xue-Han,n ZENG Jun,28ZHANG Pian-Pong,J GONG Jian-ping,29GUO Zeng-ping,1HU Jun-Po,30MENG Qing-Pua, 31LI Zeng-ning,32QIAN Su-pun,33QIN BaoP—34SHEN Sheng-rong,31TIAN Zi-Pm,36XU Hong-xi-,1Y4O Ying,37YU Le-cheng,38SHI Han-ping;Chinese Society foe Parenterai and Enteral Nutrition,Chinese Society of Nutritional Oncology1Tongji Hospital,Tongji Medical College,HuaZhong University o Scienco and TecOnology,Wuhan430030,Hubei,China;；Beijing Hospital/National Centee oo Gerontology,Beiing100730,China;3Peking University Peopld Hospital,Beeing100044,China;；General Hospital o Tianjin Medical University,Tianjin300022,China;5The Firsi affiliateg Hospital Jinan University,Guangzhou210630,基金项目：国家重点研发计划项目(2017YFC1309200)通讯作者:石汉平，电子邮箱:shihp@韦军民，电子邮箱:weijunmin'Guangdong,China;6The Second#filiated Hospital of Nanchang University,Nanchang330006)Jiangxi,China;7The First#filiated Hospital of Zhengzhou University,Zhengzhoo450052)Henan,CCina;；Tente People—Hospital of Tongji University,Shanghai200072, China;；Union Hospital,Tongji Medical C ollege,Huazhoog University o Science and TecOnology,Wuhan430022,Hubei,China;；Chinese Academy o Medical Sciencet Cancer Hospital,Beeing100029,China;11Nanjing Drum Tooer Hospital,ae effiliatee Hospital o Nanjing University Medical School,Nanjing210008,Jiangsu,China;n Sichuan Accdery o Meeical Sciences&Sichuan Provincial People's Hospital,Chengdu610072,Sichuan,China;13Peking Unioo Medial College Hospital,Bering100730,China;"The First #iliated Hospital Zhriang University School oMedicine,Hangzhoo310003,Zhejiang,China;15Guizhoo Proincial Peoplee Hospital, Guiyang550002,Guizhou,China;16Wuhan No.1Hospital,Wuhan430022,Hubei,China;“Wesi China Hospital o Sichuan University,Chengdu610041,Hubei,China;18Hainan Medical University,Haikoo571199,Hainan,China;19General Hospital o Central Was Zone oo the Chinesp Peoples Liberation Arm,,Wuhan430070,Hubei,China;22The Firsi yAHiatee Hospital oo A nhui Meeical Unnerspy,Hefei230022,Anhui,China;;1Renmin Hospital eg Wuhan University,Wuhan430060,Hubei,China;22Xinhua Hospital Afiliated e Shanghai Jiaotong University School p Medicine,Shanghai200092,China;yie PLAb900Hospital p the Joint e^ogispcc Team,Fuzhou350025,Fujian,China;Tangdu Hospital,Fourty Military Meiical ej-nivepy,Xian710038,Shanxi,China; Zhongnan Hospital O Wuhan Unwersit,,Wuhan430071,Hubei,China;Beijing Tsinghua Changgung Hospital,Beijing102218, China;;Wuhan Childrens Hospital Wuhan430015,Hubei,China;Second Afiliatee Hospital,Zhejiang University Schol O Medicine,Hangzhou310009,Zhejiang,China;;9Fujian Proincc Cancer Hospital,Fujian Meiical University Afiliatee Cancer Hospital, Fuzhou350014,Fujian,China(30Beiing Youan Hospital,Capital Meiical University,Beiing100069,China；31The Firsi Hospital O Hee e l Medical University,Shniazhuang050031,Heeet,China；33Beiing Chiierens Hospital,Capital Meiical University,Beiing 100045,China；33Liaoning Tumos Hospital,Shenyang110042,Liaoning,China；3School O Public Heall,Zhejiang University, Hangzhou310058,Zhejiang,China；35The Afinated Hospital O Qingdao University,Qingdao266000,Shandong,China；36Daping Hospital,Arm,Medical University,Chongqing400042,China；37The General Hospital O Eastern Theater Commandes,O c Ba,i Hospital A^nated e Nanjing University O Chinese Medicine,Nanjing210002,Jiangsu,China；38Beijing Shijitan Hospital,Capital Meiical University,Beijing100038,ChinaAbstract:Compound amino acid infection,as the source of nitrogen in parenteral nutrition,is administrated to patients with compromised gastrointestinal function oc whose nutritional needs cannot be satisfied vie the GI tract.Therefore,compound amino acid infection is crucial in nutrition therapies.However,a consensus does not exist in China regarding its indications,formulations, dosages,and the timing of administration.Experts in the field are recruited by the Chinese Society for Parenterai and Enterai Nutrition(CSPEN)and the Chinese Society of Nutritionai Oncology(CSNO)to formulate a consensus papee The current papee aims to provide standardized guidancc foe clinicei use of compound amino acid infection.The consensus papee is a composite of systematically reviewing pertinent literature,Chinese clinical practicc,and multipla sessions of debate,discussion,and composition, with referencc to guidelines from American Society for Parenteral and Enteral Nutrition(ASPEN),European Society for Clinical Nutrition and Metabolism(ESPEN),CSPEN,and CSNO.This consensus presents10recommendations for protein needs and appropriate compound amino acid infection formulas to serve varied patients.Key wordt:Compound amino acid infection；Parenteral nutrition；Protein；Nutrition therapy；Expert consensus1、、-刖言氨基酸是构成人体营养所需蛋白质的基本物质，也是机体合成抗体、激素、酶类等其他分子的前体,在体内参与一系列代谢反应，可转变为碳水化合物和脂肪,最终代谢为二氧化碳、水及尿素，产生能量，是营养治疗的三大宏量营养素之一。