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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。SAP患者入院后如5~7 d不能经口进食应开始营养支持治疗,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,在入院48 h内开展EN对SAP的转归有积极的作用。鼻空肠(nasojejunal,NJ)营养途径仍是EN的主要方式,新近研究表明,SAP患者使用鼻胃管营养途径(NG)亦是可行的,但尚有争议。半要素或要素型EN营养制剂的使用经验和临床研究还不充分,推荐应用谷氨酰胺。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。
Nutritional support therapy plays a pivotal role in the treatment of severe acute pancreatitis (SAP). SAP patients can not be orally fed 5 to 7 days after admission should start nutritional support treatment, enteral nutrition (EN) than parenteral nutrition (PN) can reduce complications and mortality, EN is better than PN, within 48 h after admission EN to carry out the success of SAP has a positive effect. Nasal jejunum (NJ) is still the main mode of EN nutrition, recent studies have shown that SAP patients with nasogastric tube nutrition (NG) is feasible, but there is still controversy. The use of half-factor or elemental EN nutritional experience and clinical studies are not sufficient, the recommended application of glutamine. Pro-active drugs, immune-boosting EN supplements and probiotics are not routinely recommended.