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急性胰腺炎:探讨营养影响。

Acute Pancreatitis: Exploring Nutrition Implications.

机构信息

Department of Surgery, Division of Trauma/Acute Care Surgery/Critical Care, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Wauwatosa, WI, 53226, USA.

出版信息

Nutr Clin Pract. 2020 Oct;35(5):807-817. doi: 10.1002/ncp.10479. Epub 2020 Mar 17.

Abstract

Diseases of the pancreas vary by type, etiology, pathophysiology, and outcomes. One of the principle therapeutic considerations in all types of pancreatic diseases is nutrition. This review will consider acute pancreatitis (AP). Choice of patient, type and composition of nutrition, and timing of initiation will be discussed as components for achieving the maximum benefits of nutrition therapy in AP. The paradigm of nutrition therapy in AP has shifted to early enteral and/or oral nutrition based on disease severity to help mitigate the underlying inflammatory cascade of events leading to AP, beginning with anatomic and functional intestinal changes. Additionally, newer research investigating the inflammatory changes that instigate, maintain, and propagate AP will be discussed in terms of the nutrition effects on systemic inflammation. Nutrition therapy can mitigate the inflammatory changes in the intestinal tract and help with intestinal motility, bacterial overgrowth and translocation. It can help maintain intestinal bacterial composition and abundance similar to predisease levels. This review will also discuss the changes in the intestinal microbiome and effects of probiotics in AP.

摘要

胰腺疾病的类型、病因、病理生理学和结局各不相同。在所有类型的胰腺疾病中,营养都是主要的治疗考虑因素之一。本篇综述将讨论急性胰腺炎(AP)。将讨论患者选择、营养类型和组成以及起始时间,作为在 AP 中实现营养治疗最大益处的组成部分。AP 中营养治疗的模式已根据疾病严重程度转移到早期肠内和/或口服营养,以帮助减轻导致 AP 的潜在炎症级联反应,从解剖和功能的肠道变化开始。此外,还将根据营养对全身炎症的影响,讨论新的研究调查引发、维持和传播 AP 的炎症变化。营养治疗可以减轻肠道的炎症变化,并有助于肠道蠕动、细菌过度生长和易位。它有助于维持肠道细菌组成和丰度与疾病前水平相似。本篇综述还将讨论 AP 中肠道微生物组的变化和益生菌的作用。

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