重症胰腺炎的营养支持疗法

荆雪; 田字彬

重症胰腺炎的营养支持疗法

荆雪,
田字彬

青岛大学医学院附属医院消化内科

详细信息

中图分类号: R576
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出版历程
- 收稿日期: 2011-10-17
- 出版日期: 2011-11-20

Nutritional support therapy in severe acute pancreatitis

摘要

摘要: 营养支持疗法在重症急性胰腺炎(SAP)的治疗中有着举足轻重的作用,本文总结近年SAP营养支持疗法方面的热点及新观点。SAP患者入院后5～7 d不能经口进食的患者应开始营养支持。营养支持疗法中肠内营养(EN)较肠外营养(PN)能减少并发症及病死率,EN优于PN。在48 h内开展EN对SAP的转归有积极的作用。新近研究表明SAP患者使用鼻胃管营养途径(NG)是可行的,但目前尚有争议。目前半要素或要素型EN营养制剂的使用经验和临床研究还是不充分的,谷氨酰胺、促动力药、免疫增强型EN营养制剂及益生菌不作为常规推荐。
- 胰腺炎 /
- 营养支持
Abstract: Nutrition is a critical aspect in the management of severe acute pancreatitis.This review aims to systematically review the evidence available to report the use of nutritional support treatment in severe acute pancreatitis.Nutritional support therapy is indicated if patients cannot consume normal food after 5-7days of hospital admission or when it becomes evident that the patient will not be able to tolerate oral intake for a prolonged period of time (7 days or more) .EN is preferred over PN, because it reduces complications and mortality in AP.PN is only to be used in patients unable to tolerate EN.It is likely that EN has a beneficial influence on the disease course and should be initiated as early as possible (with 48 hours of admission) .It can be stated that nasogastric tube feeding in SAP is possible.The clinical evidence for the use of just (semi) elemental formulas is weak.Supplementation of enteral formulas with glutamine and prebiotics and the use of immune enhancing formulas cannot routinely be recommended.
- pancreatitis /
- nutritional support

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参考文献(34)

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