Spanier B W M, Mathus-Vliegen E M H, Tuynman H A R E, Van der Hulst R W M, Dijkgraaf M G W, Bruno M J
Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
Aliment Pharmacol Ther. 2008 Nov 1;28(9):1159-65. doi: 10.1111/j.1365-2036.2008.03814.x. Epub 2008 Jul 24.
Following a nil per os (NPO) regimen, most patients with acute pancreatitis (AP) can resume normal oral intake within 1 week. If not tolerated, it is recommended to initiate artificial feeding, preferably by the enteral route.
To evaluate the nutritional management of patients with AP in a Dutch cohort (EARL study).
Observational study in 18 hospitals. Total days of NPO, tube feeding (TF) with/without oral feeding, total parenteral nutrition (TPN) and total starvation time were analysed.
In mild AP, a majority of cases (80.7%, 117/145) were managed with an NPO regimen only. Twenty-seven patients (18.6%) with mild AP additionally received TF; one received TPN. Of those with severe AP, more than half of the patients (56.2%, nine of 16) were treated with TF besides an NPO regimen; four received TPN. TF was delivered preferably via the jejunal route. The median period of total starvation was 2 days for both mild and severe AP. Only 5.5% (nine of 164) of patients had a prolonged starvation time of more than 5 days.
The total time of starvation was limited in a majority of patients admitted for AP. According to international guidelines, additional nutritional interventions were quickly undertaken with enteral feeding via the jejunum as the preferred route.
遵循禁食（NPO）方案，大多数急性胰腺炎（AP）患者可在1周内恢复正常经口摄入。如果不耐受，建议开始人工喂养，最好通过肠内途径。
评估荷兰队列中AP患者的营养管理（EARL研究）。
在18家医院进行观察性研究。分析禁食总天数、有无经口喂养的管饲（TF）、全胃肠外营养（TPN）和总饥饿时间。
在轻度AP中，大多数病例（80.7%，117/145）仅采用禁食方案管理。27例（18.6%）轻度AP患者额外接受了TF；1例接受了TPN。在重度AP患者中，超过一半（56.2%，16例中的9例）除禁食方案外还接受了TF治疗；4例接受了TPN。TF最好通过空肠途径给予。轻度和重度AP的总饥饿中位数时间均为2天。只有5.5%（164例中的9例）患者的饥饿时间延长超过5天。
大多数因AP入院的患者饥饿总时间有限。根据国际指南，迅速采取了额外的营养干预措施，首选通过空肠进行肠内喂养。
