重症急性胰腺炎营养支持治疗的研究进展

摘要

Severe acute pancreatitis(SAP)is the most common fulminant disease with high mortality.A comprehensive and systematic therapeutics is the key element to save lives,an increasing focus of which is the nutritional support treat-ment.At present,the enteral nutrition has been utilized for the treatment of SAP for nearly 20 years(since 1987).In recent years,more and more attention has been paid to the indications,the proper time,the choice of nasogastric or nasojejunal feeding,the insert pattern and the nutrients of enteral nutrition.Recent studies suggest that the advantages of enteral nutri-tion include slowing the progression,preventing complications and ameliorating the prognosis of SAP,though the efficacy of premature enteral nutrition is still controversial.The fact that the nasogastric tube and nasojejunal tube offer almost the same efficacy finds general acceptance by more and more physicians.Therefore,the current research highlight is how to use the nutritional support in the treatment of SAP rationally and effectively.%重症急性胰腺炎(SAP)是一种病死率很高的暴发性疾病,全面、系统的治疗是挽救患者生命的关键,其中营养支持治疗受到越来越广泛的关注.目前肠内营养作为SAP治疗的重要组成部分,已应用了近20年(从1987年至今).近年来对于肠内营养的适应证、应用时机、鼻胃管与鼻空肠管的选择、输入方式以及营养成分等方面受到越来越多的关注.近期的研究认为肠内营养在延缓病情发展、预防并发症、改善预后等方面发挥着自身优势,但过早的期肠内营养,其疗效仍存在较大争议,而鼻胃管与鼻空肠管在营养支持治疗中具有相同疗效的观点正逐渐被更多临床医师接受.因此,如何在SAP患者中科学、合理、有效地应用营养支持是目前研究的热点.