Mayumi Toshihiko, Takezawa Jun
Department of Emergency Medicine and Critical Care, Nagoya University School of Medicine.
Nihon Rinsho. 2004 Nov;62(11):2079-85.
In this review, systematic search of literatures for acute pancreatitis and nutrition was performed. Eleven randomized controlled trials (RCT) were found. Eight of them are about parenteral or enteral nutrition, 2 are about immunomodulated nutrition, and one is nutritional method in postoperative period. None of these showed benefit of total parenteral nutrition. Moreover, enteral nutrition via nasojejunal tube after 1-2 days after onset or operation of acute pancreatitis showed safe and more effectiveness than parenteral nutrition even in severe cases. These results indicate no benefit of parenteral nutrition in mild to moderate pancreatitis. Early enteral nutrition via nasojejunal tube can be used even in severe cases without ileus or intestinal ischemia.
在本综述中,对有关急性胰腺炎与营养的文献进行了系统检索。共找到11项随机对照试验(RCT)。其中8项关于肠外或肠内营养,2项关于免疫调节营养,1项关于术后营养方法。这些研究均未显示全肠外营养的益处。此外,急性胰腺炎发病或手术后1 - 2天经鼻空肠管给予肠内营养,即使在重症病例中也比肠外营养更安全、更有效。这些结果表明,肠外营养对轻至中度胰腺炎无益处。即使在无肠梗阻或肠缺血的重症病例中,也可采用早期经鼻空肠管肠内营养。