急性胰腺炎早期肠内营养.pptVIP

肠内营养的使用量 判断肠功能状况 先使用NS250~500ml 尝试，输注速度20~30ml/h 肠内营养液500ml/d， 输注速度20~30ml/h 肠内营养液1000ml/d，输注速度50ml/h 肠内营养液1500ml/d，输注速度70ml/h 肠内营养液2000ml/d，输注速度100ml/h 何时需使用PN 仅用于 经过5-7天尝试，并证明肠内营养失败的病人 即使给予EN，但由于各种原因导致摄入能量不足的患者，需提供PN补充 JOP. J Pancreas. 2008; 9(4):375-390. Meier R, et al. ESPEN Guidelines on Enteral Nutrition: Pancreas. Clin Nutr 2006; 25:275-284 有关SAP实施EN的文献综述 McClave SA, et al. Artificial nutrition in pancreatic disease: what lessons have we learned from the literature? Clin Nutr. 2000;19(1):1-6. Erstad BL. Enteral nutrition support in acute pancreatitis. Ann Pharmacother. 2000;34(4):514-521. Lobo DN, et al. Evolution of nutritional support in acute pancreatitis. Br J Surg. 2000;87(6):695-707. 有关SAP实施EN的文献综述 4. Imrie CW, et al. Enteral and parenteral nutrition in acute pancreatitis. Best Pract Res Clin Gastroenterol. 2002;16(3):391-397. 5. Abou-Assi S, et al. Nutrition support during acute pancreatitis. Nutrition. 2002;18(11):938-943. 6. Al-Omran M, et al. Enteral versus parenteral nutrition for acute pancreatitis. Cochrane Database Syst Rev. 2003;(1):CD002837. BMJ 2004;328:1407-10. 7. BMJ 2004;328:1407-10. 7. 有关SAP实施EN的文献综述 8. McClave SA, et al. Nutrition support in acute pancreatitis: a systematic review of the literature. JPEN. 2006;30(2):143-156. 9. Thomson A. Enteral versus parenteral nutritional support in acute pancreatitis: a clinical review. J Gastroenterol Hepatol. 2006 ;21(1):22-25. 10. Koretz RL, et al. Does enteral nutrition affect clinical outcome? A systematic review of the randomized trials. Am J Gastroenterol. 2007;102(2):412-429. 有关SAP实施EN的文献综述 11. Petrov MS, et al. Influence of enteral versus parenteral nutrition on blood glucose control in acute pancreatitis: a systematic review. Clin Nutr. 2007;26(5):514-523. 12. Romics L , et al. Early enteral nutrition in acute pancreatitis--benefits and limitations. Langenbecks Arch Surg. 2008;393(3):261-269. 13.Petrov MS, et al. Advanced enteral therapy in acute pancreatitis: is there a room for immunon