早期肠内营养支持在急性重症胰腺炎治疗中的评价

Evaluate the early enteral nutrition supports in severe acute pancreatitis

目的评价治疗重症胰腺炎时实施肠内营养最佳的时机、方式、途径和制剂。方法采用medline数据库和清华数据库CNKI—CHKD（中国医院知识仓库），以severe acute pancreatitis、early enteral nutrition、急性重症胰腺炎，早期肠内营养为关键词，检索最近8年文献，并对检索到的文章进行对比研究、统计分析和评价。数据统计和分析采用SPSS11．0。结果共检索到文章43篇，其中外文20篇，中文23篇，可用文章20篇。结论早期实施全肠内营养安全有效；实施肠内营养最佳时机为肠功能恢复期，一般术后3～5d，或者保守治疗时入院后3-5d；手术者经空肠造瘘管、非手术者经鼻空肠置管至Treiz韧带30cm以下为实施肠内营养治疗急性重症胰腺炎时的首选途径；实施肠内营养时多数选用整蛋白型肠内制剂。

Objective As a clinical pharmacist to evaluate the early enteral nutrition supports the best administrating time, method, way, and preparation in the treatment of sever acute pancreatitis, in order to provide pharmacy service for clinic. Methods Adopt the data of Medline and CNKI - CHKD （Chinese hospital knowledge data） to retrieve latest 8 years references using the key words ＂severe acute pancreatitis＂ and ＂ early enteral nutrition＂ both in English and Chinese. Then analysis, comparison and evaluate these papers using SPSS 11.0. Results The total number of papers was 43 （ Foreign papers 20, Chinese paper 23, but the available paper was 20. Conclusion Perform the early enteral nutrition supports was safe and effective. The best time to carry out enteral nutrition was as intestines functions recover, about 3 -5 days after operation, or 3 -5 days hospitalization treatment if no operation. The first way to be chosen was put the tube to jejunum position 30cm below Treiz through making jejunum stoma for operation patient or through the nasal cavity for no operation patient when performing enteral nutrition in the treatment of sever pancreatitis. The most choice of preparation was polymeric diets.