Lipman T O
Gastroenterology-Hepatology-Nutrition Section, Department of Veterans Affairs Medical Center, Georgetown University School of Medicine, Washington, DC 20422, USA.
JPEN J Parenter Enteral Nutr. 1998 May-Jun;22(3):167-82. doi: 10.1177/0148607198022003167.
Enteral nutrition is said to be better than parenteral nutrition for providing nutrition support to humans.
To assess the literature documenting the assertions that enteral nutrition is superior to parenteral nutrition with respect to cost, safety, physiology, intestinal structure and function, bacterial translocation, and outcome.
Sources included MEDLINE search, personal files, and references from human comparative studies of enteral vs parenteral nutrition.
The goal was to include all human studies directly addressing questions of comparative efficacy of enteral and parenteral nutrition. Emphasis was given to prospective randomized controlled studies where available. Retrospective comparisons were not included.
An attempt was made to briefly summarize methodology and findings of relevant studies. No general attempt was made to assess quality of individual studies.
Enteral nutrition appears to be less expensive than parenteral nutrition, but new economic analyses are needed given the newer aggressive access techniques for enteral nutrition. Enteral nutrition is associated with meaningful morbidity and mortality. The little comparative data existent suggest no differences in safety. Comparative studies of physiology and metabolism as well as comparative and noncomparative studies of intestinal function and structure do not support putative advantages of enteral nutrition. There is no evidence that enteral nutrition prevents bacterial translocation in humans. Enteral nutrition probably reduces septic morbidity compared with parenteral nutrition in abdominal trauma. Otherwise, there is no evidence that enteral nutrition consistently improves patient outcome compared with parenteral nutrition.
With the exception of decreased cost and probable reduced septic morbidity in acute abdominal trauma, the available literature does not support the thesis that enteral nutrition is better than parenteral nutrition in humans.
对于为人类提供营养支持而言，肠内营养据说优于肠外营养。
评估相关文献，这些文献记录了关于肠内营养在成本、安全性、生理学、肠道结构与功能、细菌易位及结局方面优于肠外营养的论断。
资料来源包括医学主题词表（MEDLINE）检索、个人文档以及肠内营养与肠外营养人体对比研究的参考文献。
目标是纳入所有直接探讨肠内营养与肠外营养比较疗效问题的人体研究。如有可能，重点纳入前瞻性随机对照研究。不包括回顾性比较研究。
尝试简要总结相关研究的方法和结果。未全面评估个别研究的质量。
肠内营养似乎比肠外营养成本更低，但鉴于肠内营养更新的积极置管技术，需要进行新的经济分析。肠内营养与显著的发病率和死亡率相关。现有的少量比较数据表明安全性无差异。生理学和代谢的比较研究以及肠道功能与结构的比较和非比较研究均不支持肠内营养的假定优势。没有证据表明肠内营养可预防人类细菌易位。与肠外营养相比，肠内营养可能降低腹部创伤患者的脓毒症发病率。否则，没有证据表明与肠外营养相比，肠内营养能持续改善患者结局。
除了成本降低以及可能降低急性腹部创伤患者的脓毒症发病率外，现有文献并不支持肠内营养在人类中优于肠外营养这一论点。
