重症急性胰腺炎治疗中肠内营养的研究进展

Advances in the Management of Severe Acute Pancreatitis with Enteral Nutrition

营养支持在重症急性胰腺炎(SAP)患者的管理中发挥重要作用,目前已证实对SAP患者行肠内营养优于肠外营养。但肠内营养的最佳时机、最佳实施途径尚不清楚,过早行肠内营养的疗效仍存在较大争议。经鼻胃管肠内营养和经鼻空肠管肠内营养具有相同安全性及疗效的观点正逐渐被接受,但早期经口进食是否与以上两种方法一样安全有效仍需进一步研究。对于肠内营养配方,目前仍不推荐常规添加免疫微生态制剂、免疫增强制剂、膳食纤维、中药。我国有学者将雷达图运用到SAP患者肠内营养支持评估中,但如何准确进行SAP患者肠内营养评估管理仍是一个挑战。本文对以上内容的研究进展进行了综述。

Nutrition support plays an important role in the management of severe acute pancreatitis(SAP) patients. It has been proved that enteral nutrition is superior to parenteral nutrition in SAP patients.But the optimal timing and path of enteral nutrition are still unclear.The efficacy of very early enteral nutrition is still controversial,the idea that nasogastric feeding and nasal jejunal feeding have the same safety and efficacy in nutrition-support therapy is gaining acceptance,but whether early oral feeding is as safe and effective as nasogastric feeding and nasal jejunal feeding remains to be answered.For enteral nutrition formulations,it is still not routinely recommended to add immunological microecological agents,immune-enhancing agents, dietary fiber,and traditional Chinese medicine.Some Chinese scholars have applied radar chart to the assessment of enteral nutrition support in patients with SAP,but it is still a challenge to appropriately carry out the assessment and management of enteral nutrition in patients with SAP.The aforementioned developments are reviewed in detail in this paper.