肠内营养在急性胰腺炎中的研究进展

Research Progress of Enteral Nutrition in Acute Pancreatitis

摘要: 2019年中国急性胰腺炎诊治指南指出急性胰腺炎(acute pancreatitis, AP)总体病死率高达5%，重症病死率仍较高，成为危及我国人民生命健康的重大疾病之一。在AP的治疗方面，传统认为禁饮食联合肠外营养(total parenteral nutrition, TPN)，可使胰腺得以休息，同时又能补充足够生理需求。但近年来越来越多的研究认为肠内营养(enteral nutrition, EN)可通过改善肠黏膜屏障功能，降低炎症反应综合征等并发症的发生率，进而控制AP病情进展，提出EN优于TPN。然而，EN的作用机制、疗效、时机、营养管置入方式及营养成份选择等方面，国内外研究仍有较大争议。本文就AP在EN方面国内外最新进展综述如下。

Abstract: According to the 2019 acute pancreatitis guidelines, the overall case fatality rate of acute pancreatitis is as high as 5%, while the severe case fatality rate is still high, and it has become one of the major diseases endangering the life and health of the Chinese people. In the treatment of AP, it is traditionally believed that diet deprivation combined with parenteral nutrition can rest the pancreas while providing adequate physiological needs. However, in recent years, more and more studies have shown that enteral nutrition can improve the intestinal barrier function, reduce the incidence of complications, such as inflammatory and so on, further control the progress of AP, it is suggested that enteral nutrition is better than parenteral nutrition. However, there are still many controversies on the mechanism, curative effect, timing, the way of nutrition tube insertion and the choice of nutrition components. This article reviews the latest development of acute pancreatitis in nutrition at home and abroad.