Oláh Attila, Romics László
Department of Surgery, Petz Aladár Teaching Hospital, Gyor, Hungary.
Langenbecks Arch Surg. 2008 May;393(3):261-9. doi: 10.1007/s00423-008-0291-9. Epub 2008 Feb 12.
The application of enteral feeding as part of the treatment of acute pancreatitis goes back more than a decade now. In this review, the authors outline the indications and limitations of enteral feeding in the treatment of acute pancreatitis using up-to-date evidence-based data.
Latest meta-analyses suggest that early enteral feeding reduces effectively the incidence of infective complications and shortens hospital stay. In addition, recently published randomized controlled trials indicate that it may reduce mortality as well.
However, the role of immune-enhancing ingredients, such as glutamine or omega-3 fatty acids, combined with enteral nutrition is uncertain, and the published studies are too few to make any treatment recommendation. Supplementation of enteral feeding with probiotics is a potentially promising alternative, but further well-designed multi-centric trials are necessary to prove their role in the treatment of acute pancreatitis.
肠内营养作为急性胰腺炎治疗的一部分应用至今已有十多年。在本综述中，作者利用最新的循证医学数据概述了肠内营养在急性胰腺炎治疗中的适应证和局限性。
最新的荟萃分析表明，早期肠内营养可有效降低感染性并发症的发生率并缩短住院时间。此外，最近发表的随机对照试验表明，它也可能降低死亡率。
然而，免疫增强成分如谷氨酰胺或ω-3脂肪酸与肠内营养联合使用的作用尚不确定，且已发表的研究太少，无法给出任何治疗建议。肠内营养补充益生菌是一种潜在的有前景的替代方法，但需要进一步设计良好的多中心试验来证明它们在急性胰腺炎治疗中的作用。
