急性胰腺炎肠内营养的研究进展

Advances in enteral nutrition in acute pancreatitis

急性胰腺炎是临床常见的消化系统急症,因起病急、进展快、并发症多、病死率高等特点引起广泛社会关注。营养不良贯穿整个疾病过程,有效营养支持促进机体功能恢复,改善临床结局。传统观念提倡完全肠外营养,但已有越来越多证据支持早期肠内营养,维持肠道渗透性,减少肠源性感染,降低病死率。目前各国指南关于早期肠内营养的最佳时机、喂养途径尚未达成一致意见,近年提出的免疫型肠内营养疗效也备受争议。因此,本文将对急性胰腺炎肠内营养的必要性、营养时机、途径、营养物质、适应证及并发症等多方面的最新进展进行以下综述。

Acute pancreatitis is a common digestive system emergency in clinic.It attracts wide social attention because of its acute onset,rapid progress,many complications and high mortality.Malnutrition runs through the whole disease process.Effective nutritional support promotes functional recovery and improves clinical outcomes.Traditional concepts advocate total parenteral nutrition,but there is increasing evidence to support early enteral nutrition,maintain intestinal permeability,reduce intestinal infections,and reduce mortality.At present,there is no consensus on the optimal timing and feeding routes of early enteral nutrition in the guidelines of various countries,and the efficacy of immune enteral nutrition proposed in recent years has also been controversial.Therefore,this article will review the latest advances in the necessity,timing,pathway,nutrients,indications and complications of enteral nutrition in acute pancreatitis.