目的:探讨螺旋型鼻肠管幽门后喂养对急性胃肠损伤（acute gastrointestinal injury, AGI）Ⅱ级重症患者预后的影响。方法:回顾性分析2012年4月至2019年5月参与广东省人民医院3项螺旋型鼻肠管幽门后置管随机对照试验的AGIⅡ级重症患者的数据。收集患者人口统计学资料以及重症监护病房（intensive care unit, ICU）病死率等临床预后资料。根据置管24 h后鼻肠管位置将患者分为幽门后喂养组和胃内喂养组。应用倾向性评分匹配法对两组患者进行1∶1匹配，比较匹配后两组患者临床资料和预后指标的差异。然后采用单因素分析AGIⅡ级重症患者ICU死亡的因素，将n P<0.10的变量纳入多因素logistic回归分析，确定ICU死亡的影响因素。n 结果:经倾向性评分成功匹配90对患者，匹配后两组患者的基线资料差异无统计学意义。幽门后喂养组的ICU病死率、28 d病死率及院内病死率均低于胃内喂养组，分别为4.4% n vs 15.6%，14.4% n vs 27.8%，6.7% n vs 17.8%，均n P<0.05。多因素logistic回归分析发现，幽门后喂养是减少ICU死亡的独立保护因素（n OR=0.295，95%n CI：0.091~0.959，n P=0.042），APACHE Ⅱ评分是ICU死亡的独立危险因素（n OR=1.111，95%n CI：1.025~1.203，n P=0.010）。n 结论:幽门后喂养可降低AGI Ⅱ级重症患者ICU病死率，是改善患者预后的独立保护因素。“,”Objective:To explore the effect of post-pyloric feeding by spiral nasoenteric tubes on the prognosis of critically ill patients with acute gastrointestinal injury (AGI) grade Ⅱ.Methods:A retrospective study was performed to analyze the clinical data of critically ill adult patients with AGI grade Ⅱ, who were enrolled in three randomized controlled trials conducted by Guangdong Provincial People's Hospital for post-pyloric tube placement between April 2012 and May 2019. Data including demographic characteristics, serological indicators of nutrition, the tube tip position confirmed by abdominal X-ray 24 h after tube insertion, and intensive care unit (ICU), 28-day and hospital mortality were collected. Patients were divided into the post-pyloric feeding group and gastric feeding group according to the tube tip position. Propensity score matching method was used to perform 1:1 matching, and the differences of each index between the two groups were compared after matching. Then the influencing factors ofn P<0.1 were included in multivariate logistic regression analysis to investigate the potential ICU mortality risk factors of critically ill patients with AGI gradeⅡ. Factors with 0.1 level of significance from the univariate analysis were considered in the multivariate analysis.n Results:There were 90 patients in post-pyloric feeding group and 90 patients in the gastric feeding group. Demographics and clinical characteristics of study population were well balanced between the two groups after matching. ICU, 28-day and hospital mortality in the post-pyloric feeding group were significantly lower than those in the gastric feeding group (4.4% n vs 15.6%, 14.4% n vs 27.8%, 6.7% n vs 17.8%, all n P < 0.05). Multivariate logistic regression analysis indicated that post-pyloric feeding was an independent protective factor [odds ratio ( n OR)=0.295, 95% confidence internal (95%n CI): 0.091-0.959, n P=0.042] and APACHEⅡ score was an independent risk factor (n OR=1.111, 95%n CI: 1.025-1.203, n P=0.010) for ICU mortality of critically ill patients with AGI gradeⅡ.n Conclusions:Post-pyloric feeding for critically ill patients with AGI grade Ⅱ could decrease ICU mortality and is an independent protective factor against mortality.