急性重症胰腺炎的营养支持研究新进展

Reaearch Progress about Nutritional support of Severe Acute Pancreatitis

急性重症胰腺炎(SAP)是一种急性全身消耗性疾病,病死率高。肠外营养能降低并发症和病死率,但其导管相关性感染和肠源性并发症增多。近年来随着对肠内营养研究的深入,从肠内营养对胰腺外分泌和急性重症胰腺炎自然病程的影响分析,提出经空肠营养喂养不刺激胰腺分泌,也不会加重SAP的病情。而且肠内营养能够维持肠道黏膜完整性,减低其通透性,减少肠道内细菌和毒素的移位,从而减少并发症。但在临床应用中,应结合急性重症胰腺炎的分期和临床状况,采用肠外营养和肠内营养联合应用来达到营养支持的目的。

Severe acute pancreatitis （SAP） is a acute severe wasting disease of all over the body with high mortality. Parenteral alimeutation can decrease its complication and case fatality, but it can results in mote infection related to meatus and complication from bowels. With the further development of enteral nutrition research, there is a view that enteral nutrition not only does not stimulate pancreatic secretion as well as aggragate its pathogenetic condition from the analysis of influence of enteral nutrition on execrine pancreas and natural course of SAP,but also can maintain the mueosa intsgrality of intestinal tract, decrease shifting of bacteria and toxin in intestinal tract and complication. In clinical application,we should apply parcnteral alimentation combined with enternal nutrition in order to achieve nutritional support according to its staging and clinical condition.