肠内营养在儿童克罗恩病治疗中的研究进展

Enteral nutrition in pediatric Crohn＇s disease

克罗恩病（Crohn＇s disease, CD）是一种主要累及末端回肠及近端结肠的目前仍无法治愈的炎症性肠病（inflammatory bowel disease, IBD），其主要症状有腹痛、腹泻、发热，随着病情的进展可出现直肠出血、肠瘘、肠梗阻等。儿童患者可出现生长发育迟缓、青春期延迟。CD的治疗一直以来是临床医生的讨论热点，其药物治疗有诸多不良反应，手术治疗复发率高、并发症多。肠内营养疗法（enteral nutrition,EN）是指患儿经口或通过导管直接到胃或小肠的营养途径。目前研究发现EN可用于CD患儿的诱导缓解，维持缓解，并且可促进生长发育。EN已广泛运用于CD的临床治疗，特别是在儿童CD的治疗。该文通过分析近年来国内外学者对EN在CD临床治疗中的研究工作，对EN在CD治疗中的重要性、主要作用、作用机制、治疗方法及疗效影响因素等进行总结。

Crohn＇s disease （CD） is a major involvement terminal ileum and proximal colonic inflammatory bowel disease（ IBD）, by now it still cannot be cured. The main symptoms include abdominal pain, diarrhea, fever. With the progress of the disease, it can exhibit rectal bleeding, intestinal fistula intestinal obstruction, etc. Children with CD can display growth retardation and delayed puberty. The treatment of CD has been a hot spot that is being discussed by clinicians. The drug treatment has many side effects. The surgery has high recurrence rates and some complications. Enteral nutrition （EN） is a nutritional way that we can transport nutriment into stomach or small intestine through oral or tube with few side effects. It can improve the poor nutrition of the patients,induction and maintenance conditions. EN has been widely used in clinical treatment of CD, especially in paediatric CD. This paper summarizes the importance of EN in treatment of CD, the main function, mechanisms, therapy and the factors of curative effect.