切换至 "中华医学电子期刊资源库"

中华普通外科学文献(电子版) ›› 2023, Vol. 17 ›› Issue (05) : 385 -390. doi: 10.3877/cma.j.issn.1674-0793.2023.05.014

综述

重症急性胰腺炎营养支持治疗研究进展
黄翠君, 张喜玲, 刘思嘉, 刘云建()   
  1. 332005 九江市第一人民医院体检中心
    274000 菏泽市立医院输液中心
    332001 九江学院附属医院麻醉科
    332001 九江学院附属医院肝胆外科
  • 收稿日期:2023-06-16 出版日期:2023-10-01
  • 通信作者: 刘云建
  • 基金资助:
    江西省自然科学基金面上项目(20202BABL206092); 江西省教育厅科学技术研究项目(GJJ161064)

Research progress in nutritional support therapy for severe acute pancreatitis

Cuijun Huang, Xiling Zhang, Sijia Liu, Yunjian Liu()   

  1. Medical Examination Center, Jiujiang No.1 People’s Hospital, Jiujiang 332005, China
    Infusion Center, Heze Municipal Hospital, Heze 274000, China
    Department of Anesthesiology, Jiujiang University Affiliated Hospital, Jiujiang 332001, China
    Department of Hepatobiliary Surgery, Jiujiang University Affiliated Hospital, Jiujiang 332001, China
  • Received:2023-06-16 Published:2023-10-01
  • Corresponding author: Yunjian Liu
引用本文:

黄翠君, 张喜玲, 刘思嘉, 刘云建. 重症急性胰腺炎营养支持治疗研究进展[J/OL]. 中华普通外科学文献(电子版), 2023, 17(05): 385-390.

Cuijun Huang, Xiling Zhang, Sijia Liu, Yunjian Liu. Research progress in nutritional support therapy for severe acute pancreatitis[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(05): 385-390.

重症急性胰腺炎(SAP)导致许多炎症和营养障碍,SAP患者营养风险都很高。适当的营养治疗可以显著降低SAP患者的感染并发症发生率和死亡率。早期(24~48 h内开始)肠内营养(EN)是大多数患者的最佳选择,可减轻继发于胰腺炎症的胃肠运动障碍,从而保护肠道屏障功能。目前,肠外营养(PN)在SAP患者中的应用仅限于EN不可能或禁忌的情况。本文综述了SAP患者早期与延迟EN、鼻胃管与鼻空肠管EN、EN与PN以及免疫营养在SAP患者中的作用进展。

Severe acute pancreatitis (SAP) leads to numerous inflammatory and nutritional disturbances. All SAP patients are at a high nutritional risk. It has been proved that proper nutrition significantly reduces mortality rate and the incidence of infectious complications in SAP patients. Early (started within 24-48 h) enteral nutrition (EN) is optimal in most patients. EN protects gut barrier function because it decreases gastrointestinal dysmotility secondary to pancreatic inflammation. Currently, the application of parenteral nutrition (PN) in SAP is limited to those patients in whom EN is not possible or contraindicated. Early versus delayed EN, EN versus PN and the role of immunonutrition in SAP patients are discussed in this review.

[1]
Rijkers AP, van Eijck CH. Acute pancreatitis[J]. N Engl J Med, 2017, 376(6): 596-597.
[2]
Gomes CA, Di Saverio S, Sartelli M, et al. Severe acute pancreatitis: eight fundamental steps revised according to the 'PANCREAS’ acronym[J]. Ann R Coll Surg Engl, 2020, 102(8): 555-559.
[3]
Murphy AE, Codner PA. Acute pancreatitis: exploring nutrition implications[J]. Nutr Clin Pract, 2020, 35(5): 807-817.
[4]
Khaliq A, Dutta U, Kochhar R, et al. Management of acute pancreatitis: "PANCREAS" contains eight easy steps to remember the treatment[J]. JOP, 2010, 11(5): 492-493.
[5]
Kanthasamy KA, Akshintala Vs, Singh VK. Nutritional management of acute pancreatitis[J]. Gastroenterol Clin North Am, 2021, 50(1): 141-150.
[6]
Yi F, Ge L, Zhao J, et al. Meta-analysis: total parenteral nutrition versus total enteral nutrition in predicted severe acute pancreatitis[J]. Intern Med, 2012, 51(6): 523-530.
[7]
Cao YXu YLu T,et al. Meta-analysis of enteral nutrition versus total parenteral nutrition in patients with severe acute pancreatitis[J]. Ann Nutr Metab, 2008, 53(3-4): 268-275.
[8]
Weimann A, Felbinger TW. Gastrointestinal dysmotility in the critically ill: A role for nutrition[J]. Curr Opin Clin Nutr Metab Care, 2016, 19(5): 353-359.
[9]
Hongyin L, Zhu H, Tao W, et al. Abdominal paracentesis drainage improves tolerance of enteral nutrition in acute pancreatitis: A randomized controlled trial[J]. Scand J Gastroenterol, 2017, 52(4): 389-395.
[10]
Sun JK, Mu XW, Li WQ, et al. Effects of early enteral nutrition on immune function of severe acute pancreatitis patients[J]. World J Gastroenterol, 2013, 19(6): 917-922.
[11]
Song J, Zhong Y, Lu X, et al. Enteral nutrition provided within 48 h after admission in severe acute pancreatitis: A systematic review and meta-analysis[J]. Medicine(Baltimore), 2018, 97: e11871.
[12]
Li JY, Yu T, Chen GC, et al. Enteral nutrition within 48 h of admission improves clinical outcomes of acute pancreatitis by reducing complications: A meta-analysis[J]. PLoS One, 2013, 8: e64926.
[13]
McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)[J]. JPEN J Parenter Enteral Nutr, 2016, 40(2): 159-211.
[14]
Singh N, Sharma B, Sharma M, et al. Evaluation of early enteral feeding through nasogastric and nasojejunal tube in severe acute pancreatitis: A noninferiority randomized controlled trial[J]. Pancreas, 2012, 41(1): 153-159.
[15]
Nally DM, Kelly EG, Clarke M, et al. Nasogastric nutrition is efficacious in severe acute pancreatitis: A systematic review and meta-analysis[J]. Br J Nutr, 2014, 112(11): 1769-1778.
[16]
Petrov MS, Loveday BP, Pylypchuk RD, et al. Systematic review and meta-analysis of enteral nutrition formulations in acute pancreatitis[J]. Br J Surg, 2009, 96(11): 1243-1252.
[17]
Endo A, Shiraishi A, Fushimi K, et al. Comparative effectiveness of elemental formula in the early enteral nutrition management of acute pancreatitis: A retrospective cohort study[J]. Ann Intensive Care, 2018, 8(1): 69.
[18]
Zhang SY, Liang ZY, Yu WQ, et al. Early enteral nutrition with polymeric feeds was associated with chylous ascites in patients with severe acute pancreatitis[J]. Pancreas, 2014, 43(4): 553-558.
[19]
Liang XY, Wu XA, Tian Y, et al. Effects of early versus delayed feeding in patients with acute pancreatitis: A systematic review and meta-analysis[J]. J Clin Gastroenterol, 2023, doi: 10.1097/MCG.0000000000001886.
[20]
Jablońska B, Mrowiec S. The role of immunonutrition in patients undergoing pancreaticoduodenectomy[J]. Nutrients, 2020, 12(9): 2547.
[21]
Poropat G, Giljaca V, Hauser G, et al. Enteral nutrition formulations for acute pancreatitis[J]. Cochrane Database Syst Rev, 2015, (3): CD010605.
[22]
Jafari T, Feizi A, Askari G, et al. Parenteral immunonutrition in patients with acute pancreatitis: A systematic review and meta-analysis[J]. Clin Nutr, 2015, 34(1): 35-43.
[23]
Zhou J, Xue Y, Liu Y, et al. The effect of immunonutrition in patients with acute pancreatitis: A systematic review and meta-analysis[J]. J Hum Nutr Diet, 2021, 34(2): 429-439.
[24]
王迎芝, 张先进, 杨士彦. 益生菌结合早期肠内营养对重症急性胰腺炎患者营养状况、肠黏膜屏障功能及肠内营养耐受性的影响[J/CD]. 中华消化病与影像杂志(电子版), 2023, 13(1): 55-58.
[25]
Gou S, Yang Z, Liu T, et al. Use of probiotics in the treatment of severe acute pancreatitis: A systematic review and meta-analysis of randomized controlled trials[J]. Crit Care, 2014, 18(2): R57.
[26]
Besselink MG, van Santvoort HC, Buskens E, et al. Probiotic prophylaxis in predicted severe acute pancreatitis: A randomised, double-blind, placebo-controlled trial[J]. Lancet, 2008, 371(9613): 651-659.
[27]
Wang G, Wen J, Xu L, et al. Effect of enteral nutrition and ecoimmunonutrition on bacterial translocation and cytokine production in patients with severe acute pancreatitis[J]. J Surg Res, 2013, 183(2): 592-597.
[28]
Arvanitakis M, Ockenga J, Bezmarevic M, et al. ESPEN guideline on clinical nutrition in acute and chronic pancreatitis[J]. Clin Nutr, 2020, 9(3): 612-631.
[29]
Crockett SD, Wani S, Gardner TB, et al. American Gastroenterological Association Institute Guideline on initial management of acute pancreatitis[J]. Gastroenterology, 2018, 154(4): 1096-1101.
[30]
Wu LM, Sankaran SJ, Plank LD, et al. Meta-analysis of gut barrier dysfunction in patients with acute pancreatitis[J]. Br J Surg, 2014, 101(13): 1644-1656.
[31]
刘世洲, 姚佳柔, 莫绍剑, 等. 重症急性胰腺炎营养支持研究进展[J/CD]. 中华肝脏外科手术学电子杂志, 2021, 10(5): 533-535.
[1] 陆婷, 范晴敏, 王洁, 万晓静, 许春芳, 董凤林. 超声引导下经皮穿刺置管引流对重症急性胰腺炎的疗效及应用时机的选择[J/OL]. 中华医学超声杂志(电子版), 2024, 21(05): 511-516.
[2] 孙加奎, 李晶晶, 周学慧, 邓一航, 顾海雷, 阚小华, 袁受涛, 王翔. 超声引导非螺旋型鼻肠管置入技术在重症患者中的应用[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(02): 140-144.
[3] 朱金伟, 陆件, 宁文娜, 陈亚欧. 基于肠道生物标志物探讨三种营养策略对重度胃肠损伤患者的价值[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(02): 111-117.
[4] 宫丹丹, 孙飞飞, 于健, 姜晓东. 重症急性胰腺炎死亡风险因素分析及风险评估模型建立[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(01): 19-25.
[5] 王招娣, 孙丽丽, 温佩婷, 吴坤. 成人肠外营养患者住院期间胰岛素添加管理的证据总结[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(01): 32-38.
[6] 李鹏, 崔庆伟, 张盼, 唐浩, 庄梦梦, 孙晗, 孙媛, 李丹, 陈文娣, 毛学飞, 孙勇. 应用床旁超声监测胃残余量指导重症烧伤患者早期肠内营养的临床价值[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(01): 24-33.
[7] 王晓梅, 刘冰, 马丽琼, 卢祖静, 苗建军. 基于LASSO-Cox回归分析的非轻症急性胰腺炎死亡风险列线图预测模型的建立和临床应用效果分析[J/OL]. 中华普通外科学文献(电子版), 2024, 18(01): 44-50.
[8] 党军强, 杨雁灵, 汪庆强, 尚琳, 朱磊, 项红军. 主动经皮穿刺引流治疗重症急性胰腺炎并发急性坏死物积聚的疗效分析[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 671-674.
[9] 黄海, 程必盛, 黄健. 2024年欧洲泌尿外科学会年会:前列腺癌研究的前沿探索与未来趋势[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(03): 202-207.
[10] 龚财芳, 赵俊宇, 游川. 围手术期肠内营养在肝癌肝切除患者中有效性及安全性的Meta分析[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 551-556.
[11] 黄瑞, 王玉萍, 孙倩, 侯晓红. ICU患者肠内营养并发腹泻最佳证据的审查指标及障碍因素分析[J/OL]. 中华重症医学电子杂志, 2024, 10(01): 38-41.
[12] 丛黎, 马林, 陈旭, 李文文, 张亮亮, 周华亭. 改良CT严重指数联合炎症指标在重症急性胰腺炎患者胰腺感染预测及预后评估中的研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(05): 432-436.
[13] 宋燕秋, 戚桂艳, 杨双双, 周萍. 重症急性胰腺炎肠道菌群特征及早期肠内营养联合微生态制剂治疗的临床价值[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(05): 442-447.
[14] 汪纾羽, 焦茹, 石运涛. 早期肠内营养和微生态免疫肠内营养对重症急性胰腺炎患者肾损伤的预防效果及影响因素[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(02): 132-136.
[15] 张雯, 宋牡丹, 邓雪婷, 张云. 强化营养支持辅助奥曲肽治疗肝硬化合并食管胃底静脉曲张破裂出血的疗效及再出血危险因素[J/OL]. 中华消化病与影像杂志(电子版), 2023, 13(06): 456-460.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?