Department of Gastroenterology, Changi General Hospital, Singapore.
J Dig Dis. 2012 Sep;13(9):445-52. doi: 10.1111/j.1751-2980.2012.00611.x.
Acute pancreatitis can present as a mild or severe disease. Most patients have a mild disease and recover without requiring nutritional support. Patients with severe acute pancreatitis may develop systemic inflammatory response syndrome and progress to multi-organ failure. These ill patients have high metabolism and protein catabolism. Hence, the nutritional management of these patients can be challenging. The aim of nutritional support is to meet the elevated metabolic demands as far as possible without stimulating pancreatic secretion and yet maintaining the gut integrity. The concept of pancreatic rest has evolved over the years. To date, there is a substantial scientific proof that enteral nutrition (EN) in comparison to parenteral nutrition significantly reduces infectious complications, surgical interventions and mortality in predicted severe acute pancreatitis. EN may be able to improve outcome in these patients if given early. In this review, we summarized the current knowledge on nutrition in acute pancreatitis and shared our local experience.
急性胰腺炎可表现为轻症或重症。多数患者为轻症，无需营养支持即可康复。重症急性胰腺炎患者可能发生全身炎症反应综合征，并进展为多器官功能衰竭。这些重症患者代谢率高，蛋白分解代谢旺盛。因此，这类患者的营养管理颇具挑战。营养支持的目的是在尽量满足代谢需求的同时避免刺激胰腺分泌，并维持肠道完整性。多年来，人们对胰腺休息的概念有了更深入的认识。迄今为止，大量科学证据表明，与肠外营养相比，肠内营养可显著降低预测性重症急性胰腺炎患者的感染性并发症、手术干预和死亡率。如果早期给予肠内营养，可能会改善这些患者的预后。在这篇综述中，我们总结了急性胰腺炎营养方面的现有知识，并分享了我们的本地经验。
