Krishnan Kumar
Division of Gastroenterology, Department of Internal Medicine, Houston Methodist Hospital, Weill Cornell Medical College, Houston, Texas, USA.
Curr Opin Gastroenterol. 2017 Mar;33(2):102-106. doi: 10.1097/MOG.0000000000000340.
Acute pancreatitis is one of the most common causes for hospitalization related to a gastrointestinal disorder. It carries significant morbidity, and when severe, significant mortality. Multiple interventions have been studied to treat pancreatitis. Of all these interventions, none is more important or impactful than nutrition.
High-quality evidence along with society guidelines have recommended the use of enteral nutrition over parenteral nutrition in patients with pancreatitis. Recent systematic reviews and meta-analyses have been published and will be reviewed here.
The use of enteral nutrition has been demonstrated to decrease mortality and infectious complications compared with parenteral nutrition. The ideal timing of initiating enteral nutrition is not clear, however, early nutrition (within 48 h) appears to be safe and tolerated. Most studies have utilized nasojejunal feeding tubes; however, some patients may tolerate nasogastric or even oral refeeding. Clinicians who manage patients with pancreatitis must be aware of the critical role of nutrition in preventing pancreatitis-related complications.
急性胰腺炎是因胃肠道疾病住院的最常见原因之一。它具有较高的发病率,严重时会导致显著的死亡率。人们已经研究了多种治疗胰腺炎的干预措施。在所有这些干预措施中,没有什么比营养更重要或更有影响力。
高质量证据以及社会指南推荐在胰腺炎患者中使用肠内营养而非肠外营养。近期已发表了一些系统评价和荟萃分析,本文将对其进行综述。
与肠外营养相比,肠内营养的使用已被证明可降低死亡率和感染性并发症。然而,开始肠内营养的理想时机尚不清楚,不过早期营养支持(48小时内)似乎是安全且可耐受的。大多数研究使用鼻空肠饲管;然而,一些患者可能耐受鼻胃管甚至口服重新喂养。治疗胰腺炎患者 的临床医生必须意识到营养在预防胰腺炎相关并发症中的关键作用。