存在肠内营养禁忌证,或肠内营养不能满足患儿营养需求时,全肠外营养(TPN)或补充性肠外营养(PN)是必需的、安全的。但对其开始时机尚存在争议,研究结果也不尽一致。现有研究认为,低营养风险患儿在入重症监护病房(ICU)7 d后开始PN治疗会受益更多。对高营养风险的危重患儿,入ICU 3 d后给予适度PN治疗,并监测营养代谢状态及对治疗的反应是目前可行的方案。 Total enteral nutrition (TPN) or supplemental parenteral nutrition (PN) is necessary and safe when there is a contraindication to enteral nutrition or if enteral nutrition does not meet the nutritional needs of the child. However, its timing is still controversial, the research results are not the same. Current research suggests that children with low nutritional risk may benefit from starting PN treatment 7 days after admission to intensive care unit (ICU). In critically ill children at high nutritional risk, appropriate PN therapy administered 3 days after ICU entry and monitoring of nutritional metabolic status and response to treatment is currently a viable option.