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重症急性胰腺炎(SAP)是临床常见的急危重症，病死率高，特有的高代谢和过度炎症反应状态显现营养治疗的重要性和特殊性。肠内营养(EN)是SAP患者首要的营养治疗方法，许多证据支持其早期应用以改善临床结局，但在EN启动时机、喂养部位和配方选择等方面，目前尚未达成一致意见。文中回顾了SAP EN研究的最新进展，结合临床实践认为，EN是SAP患者首选和重要的营养治疗方法；血流动力学基本稳定后及时启动EN可获得较好的临床收益，而不应局限在24 h或48 h。经胃喂养或口服是目前SAP患者EN途径的趋势，出现胃排空障碍等情况后，可选择鼻空肠喂养。SAP早期EN可选择整蛋白(不含膳食纤维)的标准制剂，是否添加益生菌或免疫营养素(谷氨酰胺、ω-3脂肪酸)尚缺乏足够的证据。“,”Severe acute pancreatitis is an acute and severe disease commonly seen in clinical practice, with high fatality rate and characteristic high metabolism and excessive inflammatory response show the importance and particularity of nutritional therapy. Enteral nutrition is the primary nutritional support for severe acute pancreatitis, and there is much evidence to support its early use to improve clinical outcomes. However, no a greement has been reached on the timing, feeding site and formula selection of enteral nutrition. This paper reviews the latest progress in the study of enteral nutrition in severe acute pancreatitis, combined with clinical practice, it is believed that enteral nutritionis the first choice and important nutritional support for severe acute pancreatitis patients. Better clinical benefits can be obtained by starting enteral nutrition in time after the hemo dynamics is basically stable, but should not be limited to 24 or 48 hours. Gastric feeding, including oral administration for some patients, is the current trend of enteral nutritionpathway in SAP patients, and nasojejunal tube feeding can be selected after gastric emptying disorders. Eenteral nutrition in severe acute pancreatitis can be selected as a standard preparation of whole protein (without dietary fiber), and there is insufficient evidence to add probiotics and immune nutrients (glutamine, omega-3 fatty acids).