外科重症病人处于高分解代谢状态，常伴发全身炎性反应，营养物质需求显著增加。营养支持治疗是外科重症病人的重要措施之一。施行合理的营养支持应综合考虑病人的器官功能及耐受能力，选取合适的喂养途径及时机，提供适当的营养底物，监测营养支持的过程，预防并发症的发生。应用特殊营养素有助于改善机体重要脏器和免疫功能，降低并发症发生率和病死率，缩短住院时间。

Metabolic changes and nutrition support management in surgical critically ill patients        WANG Xin-ying.Department of General Surgery, Jinling Hospital, Medical School, Nanjing University, Nanjing 210002, China
Abstract    Surgical critically ill patients are hypermetabolic, accompanying with the system inflammation response and increased nutrient requirement. Nutrition support is now considered as an important part of therapy for critically ill patients. Rational nutrition support implement should be based on the overall consideration of organ function and enteral nutrition tolerability in surgical critically ill patients, including the appropriate substrate, timing, route and monitoring. Clinical studies also demonstrate that some new formulae enriched with specific nutrients may improve the organ and immune function, decrease the incidence of morbidity and mortality, and shorten the hospital stay in critically ill patients.