|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Effects of early enteral nutrition on immune function of severe acute pancreatitis patients显示文摘AIM:To investigate the effects of early enteral nutrition (EEN) on the immune function and clinical outcome of patients with severe acute pancreatitis (SAP).METHODS:Patients were randomly allocated to receive EEN or delayed enteral nutrition (DEN).Enteral nutrition was started within 48 h after admission in EEN group,whereas from the 8 th day in DEN group.All the immunologic parameters and C-reactive protein (CRP) levels were collected on days 1,3,7 and 14 after admission.The clinical outcome variables were also recorded.RESULTS:Sixty SAP patients were enrolled to this study.The CD4+ T-lymphocyte percentage,CD4+/CD8+ ratio,and the CRP levels in EEN group became significantly lower than in DEN group from the 7 th day after admission.In contrast,the immunoglobulin G(IgG) levels and human leukocyte antigen-DR expression in EEN group became significantly higher than in DEN group from the 7 th day after admission.No difference of CD8+ T-lymphocyte percentage,IgM and IgA levels was found between the two groups.The incidences of multiple organ dysfunction syndrome,systemic inflammatory response syndrome,and pancreatic infection as well as the duration of intensive care unit stay were significantly lower in EEN group than in DEN group.However,there was no difference of hospital mortality between the two groups.CONCLUSION:EEN moderates the excessive immune response during the early stage of SAP without leading to subsequent immunosuppression.EEN can improve the clinical outcome,but not decrease the hospital mortality of SAP patients. | Jia-Kui Sun Xin-Wei Mu Wei-Qin Li Zhi-Hui Tong Jing Li Shu-Yun Zheng | 2013 | World Journal of Gastroenterology2013，19，6： | 106 |
| 2 | 营养不良的五阶梯治疗显示文摘营养不良(本文特指营养不足)无论在住院患者、还是社区人群都是一个严重问题,老年人、恶性肿瘤及其他良性慢性消耗性疾病患者是营养不良的高发人群。营养不良的严重后果众所周知,而营养不良的规范治疗仍然是一个有待讨论的问题。我们认为:营养不良治疗的基本要求应该是满足能量、蛋白质、液体及微量营养素的目标需要量,即要求四达标;最高目标是调节异常代谢、改善免疫功能、控制疾病(如肿瘤)。 | 石汉平 许红霞 李苏宜 曹伟新 李薇 巴一 陈公琰 王昆华 齐玉梅 陈子华 于康 江华 胡雯 丛明华 陈俊强 李增宁 方玉 葛声 王新颖 林源 管文贤 罗琪 | 2015 | 肿瘤代谢与营养电子杂志2015，2，1： | 268 |
| 3 | Enteral nutrition in acute pancreatitis:A review of the current evidence显示文摘The use of enteral feeding as part of the management of acute pancreatitis dates back almost two decades.This review describes the indications for and limitations of enteral feeding for the treatment of acute pancreatitis using up-to-date evidence-based data.A systematic review was carried out to analyse current data on the use of enteral nutrition in the management of acute pancreatitis.Relevant literature was analysed from the viewpoints of enteral vs parenteral feeding,early vs delayed enteral nutrition,nasogastric vs nasojejunal feeding,and early oral diet and immunonutrition,particularly glutamine and probiotic supplementation.Finally,current applicable guidelines and the effects of these guidelines on clinical practice are discussed.The latest meta-analyses suggest that enteral nutrition significantly reduces the mortality rate of severe acute pancreatitis compared to parenteral feeding.To maintain gut barrier function and prevent early bacterial translocation,enteral feeding should be commenced within the first 24 h of hospital admission.Also,the safety of nasogastric feeding,which eases the administration of enteral nutrients in the clinical setting,is likely equal to nasojejunal feeding.Furthermore,an earlylow-fat oral diet is potentially beneficial in patients with mild pancreatitis.Despite the initial encouraging results,the current evidence does not support the use of immunoenhanced nutrients or probiotics in patients with acute pancreatitis. | Attila Oláh Laszlo Romics Jr | 2014 | World Journal of Gastroenterology2014，20，43： | 81 |
| 4 | Modulation of postoperative immune and inflammatory response by immune-enhancing enteral diet in gastrointestinal cancer patients显示文摘AIM To evaluate if the administration of anenteral diet supplemented with glutamine,arginine and ω-3-fatty acids modulatesinflammatory and immune responses aftersurgery.METHODS A prospective randomized double-blind, clinical trial was performed. Forty-eightpatients with gastrointestinal cancer wererandomized into two groups, one group wasgiven an isocaloric and isonitrogenous standarddiet and the other was fed with the supplementeddiet with glutamine, arginine and ωo-3-fattyacids. Feedings were started within 48 hoursafter operation, and continued until day 8. Allvariables were measured before operation andon postoperative day 1 and 8. Immune responseswere determined by phagocytosis ability,respiratory burst of polymorphonuclear cells,total lymphocytes lymphocyte subsets, nitricoxide, cytokines concentration, andinflammatory responses by plasma levels of C-reactive protein, prostaglandin E2 level.RESULTS Tolerance of both formula diets wasexcellent. There were siagnificant differences inthe immunological and inflammatory responsesbetween the two groups. In supplementedgroup, phagocytosis and respiratory burst aftersurgery was higher and C-reactive protein levelwas lower (P<0.01) than in the standard group.The supplemented group had higher levels ofnitric oxide, total Iymphocytes, T lymphocytes,T-helper cells, and NK cells. Postoperativelevels of IL-6 and TNF-α were lower in thesupplemented group ( P < 0.05).CONCLUSION It was clearly established in thistrial that early postoperative enteral feeding issafe in patients who have undergone majoroperations for gastrointestinal cancer.Supplementation of enteral nutrition withglutamine, arginine, and ω-3 fatty acidspositively modulated postsurgicalimmunosuppressive and inflammatoryresponses. | Guo Hao Wu Yan Wei Zhang Zhao Han Wu Department of General Surgery.zhongshan Hospital,ShangHai Medical University.ShangHai 200032.China | 2001 | World Journal of Gastroenterology2001，7，3： | 67 |
| 5 | Gastroenteric tube feeding: Techniques, problems and solutions显示文摘Gastroenteric tube feeding plays a major role in the management of patients with poor voluntary intake,chronic neurological or mechanical dysphagia or gut dysfunction,and patients who are critically ill.However,despite the benefits and widespread use of enteral tube feeding,some patients experience complications.This review aims to discuss and compare current knowledge regarding the clinical application of enteral tube feeding,together with associated complications and special aspects.We conducted an extensive literature search on PubMed,Embase and Medline using index terms relating to enteral access,enteral feeding/nutrition,tube feeding,percutaneous endoscopic gastrostomy/jejunostomy,endoscopic nasoenteric tube,nasogastric tube,and refeeding syndrome.The literature showed common routes of enteral access to include nasoenteral tube,gastrostomy and jejunostomy,while complications fall into four major categories:mechanical,e.g.,tube blockage or removal;gastrointestinal,e.g.,diarrhea;infectious e.g.,aspiration pneumonia,tube site infection;and metabolic,e.g.,refeeding syndrome,hyperglycemia.Although the type and frequency of complications arising from tube feeding vary considerably according to the chosen access route,gastrointestinal complications are without doubt the most common.Complications associated with enteral tube feeding can be reduced by careful observance of guidelines,including those related to food composition,administration rate,portion size,food temperature and patient supervision. | Irina Blumenstein Yogesh M Shastri Jürgen Stein | 2014 | World Journal of Gastroenterology2014，20，26： | 63 |
| 6 | Early Enteral Combined with Parenteral Nutrition Treatment for Severe Traumatic Brain Injury:Effects on Immune Function,Nutritional Status and Outcomes显示文摘Objective To compare the conjoint effect of enteral nutrition (EN) and parenteral nutrition (PN)with single EN or PN on immune function, nutritional status, complications and clinical outcomes of patientswith severe traumatic brain injury (STBI).Methods A prospective randomized control trial was carried out from January 2009 to May 2012 inNeurological Intensive Care Unit (NICU). Patients of STBI who met the enrolment criteria (Glasgow ComaScale score 6~8; Nutritional Risk Screening ≥3) were randomly divided into 3 groups and were administratedEN, PN or EN+PN treatments respectively. The indexes of nutritional status, immune function,complications and clinical outcomes were examined and compared statistically. | Ming-chao Fan Qiao-ling Wang Wei Fang Yun-xia Jiang Lian-di Li Peng Sun Zhi-hong Wang | 2016 | Chinese Medical Sciences Journal2016，31，4： | 37 |
| 7 | Percutaneous endoscopic gastrostomy:Indications,technique,complications and management显示文摘Percutaneous endoscopic gastrostomy(PEG)is the preferred route of feeding and nutritional support in patients with a functional gastrointestinal system who require long-term enteral nutrition.Besides its wellknown advantages over parenteral nutrition,PEG offers superior access to the gastrointestinal system over surgical methods.Considering that nowadays PEG tube placement is one of the most common endoscopic procedures performed worldwide,knowing its indications and contraindications is of paramount importance in current medicine.PEG tubes are sometimes placed inappropriately in patients unable to tolerate adequate oral intake because of incorrect and unrealistic understanding of their indications and what they can accomplish.Broadly,the two main indications of PEG tube placement are enteral feeding and stomach decompression.On the other hand,distal enteral obstruction,severe uncorrectable coagulopathy and hemodynamic instability constitute the main absolute contraindications for PEG tube placement in hospitalized patients.Although generally considered to be a safe procedure,there is the potential for both minor and major complications.Awareness of these potential complications,as well as understanding routine aftercare of the catheter,can improve the quality of care for patients with a PEG tube.These complications can generally be classified into three major categories:endoscopic technical difficulties,PEG procedure-related complications and late complications associated with PEG tube use and wound care.In this review we describe a variety of minor and major tube-related complications as well as strategies for their management and avoidance.Different methods of percutaneous PEG tube placement into the stomach have been described in the literature with the'pull'technique being the most common method.In the last section of this review,the reader is presented with a brief discussion of these procedures,techniques and related issues.Despite the mentioned PEG tube placement complications,this procedure has gained worldwide popularity as a safe enteral access for nutrition in patients with a functional gastrointestinal system. | Ata A Rahnemai-Azar Amir A Rahnemaiazar Rozhin Naghshizadian Amparo Kurtz Daniel T Farkas | 2014 | World Journal of Gastroenterology2014，20，24： | 38 |
| 8 | Effect of early enteral combined with parenteral nutrition in patients undergoing pancreaticoduodenectomy显示文摘AIM:To investigate the effect of early enteral nutrition(EEN)combined with parenteral nutritional support in patients undergoing pancreaticoduodenectomy(PD).METHODS:From January 2006,all patients were given EEN combined with parenteral nutrition(PN)(EEN/PN group,n=107),while patients prior to this date were given total parenteral nutrition(TPN)(TPN group,n=67).Venous blood samples were obtained for a nutrition-associated assessment and liver function tests on the day before surgery and 6 d after surgery.The assessment of clinical outcome was based on postoperative complications.Follow-up for infectious and noninfectious complications was carried out for 30 d after hospital discharge.Readmission within 30 d afterdischarge was also recorded.RESULTS:Compared with the TPN group,a significant decrease in prealbumin(PAB)(P=0.023)was seen in the EEN/PN group.Total bilirubin(TB),direct bilirubin(DB)and lactate dehydrogenase(LDH)were significantly decreased on day 6 in the EEN/PN group(P=0.006,0.004 and 0.032,respectively).The rate of gradeⅠcomplications,gradeⅡcomplications and the length of postoperative hospital stay in the EEN/PN group were significantly decreased(P=0.036,0.028and 0.021,respectively),and no hospital mortality was observed in our study.Compared with the TPN group(58.2%),the rate of infectious complications in the EEN/PN group(39.3%)was significantly decreased(P=0.042).Eleven cases of delayed gastric emptying were noted in the TPN group,and 6 cases in the EEN/PN group.The rate of delayed gastric emptying and hyperglycemia was significantly reduced in the EEN/PN group(P=0.031 and P=0.040,respectively).CONCLUSION:Early enteral combined with PN can greatly improve liver function,reduce infectious complications and delayed gastric emptying,and shorten postoperative hospital stay in patients undergoing PD. | Xin-Hua Zhu Ya-Fu Wu Yu-Dong Qiu Chun-Ping Jiang Yi-Tao Ding | 2013 | World Journal of Gastroenterology2013，19，35： | 34 |
| 9 | Effects of early enteral nutrition on Th17/Treg cells and IL-23/IL-17 in septic patients显示文摘BACKGROUND The imbalance of Th17/Treg cells and the IL-23/IL-17 axis have been confirmed to be associated with sepsis and various inflammatory diseases. Early enteral nutrition (EEN) can modulate the inflammatory response, improve immune dysfunction, and prevent enterogenic infection in critically ill patients;however, the precise mechanisms remain unclear. Considering the important roles of Th17 and Treg lymphocytes in the development of inflammatory and infectious diseases, we hypothesized that EEN could improve the immune dysfunction in sepsis by maintaining a balanced Th17/Treg cell ratio and by regulating the IL- 23/IL-17 axis. AIM To investigate the effects of EEN on the Th17/Treg cell ratios and the IL-23/IL-17 axis in septic patients. METHODS In this prospective clinical trial, patients were randomly divided into an EEN or delayed enteral nutrition (DEN) group. Enteral feeding was started within 48 h in the EEN group, whereas enteral feeding was started on the 4th day in the DEN group. The Th17 and Treg cell percentages and the interleukin levels were tested on days 1, 3, and 7 after admission. The clinical severity and outcome variables were also recorded. RESULTS Fifty-three patients were enrolled in this trial from October 2017 to June 2018. The Th17 cell percentages, Th17/Treg cell ratios, IL-17, IL-23, and IL-6 levels of the EEN group were lower than those of the DEN group on the 7th day after admission (P < 0.05). The duration of mechanical ventilation and of the intensive care unit stay of the EEN group were shorter than those of the DEN group (P <0.05). However, no difference in the 28-d mortality was found between the two groups (P = 0.728). CONCLUSION EEN could regulate the imbalance of Th17/Treg cell ratios and suppress the IL- 23/IL-17 axis during sepsis. Moreover, EEN could reduce the clinical severity of sepsis but did not reduce the 28-d mortality of septic patients. | Jia-Kui Sun Wen-Hao Zhang Wen-Xiu Chen Xiang Wang Xin-Wei Mu | 2019 | World Journal of Gastroenterology2019，25，22： | 27 |
| 10 | Nutrition management in acute pancreatitis: Clinical practice consideration显示文摘Acute pancreatitis(AP)is a common gastrointestinal disease and the leading cause of hospital admission and healthcare burden among gastrointestinal disorders in many countries.Patients can present with varying degrees of inflammation and disease severity,ranging from self-limiting mild AP to devastating and fatal severe AP.Many factors contribute to malnutrition in AP,especially abnormal metabolism and catabolism related to inflammation.The concept of“pancreatic rest”is not evidence-based.There is however,emerging evidence that supports the use of oral or enteral nutrition to improve nutrition status and to reduce local and systemic inflammation,complications,and death.In mild disease,patients are generally able to initiate solid oral diet and do not require specialized nutrition care such as enteral or parenteral nutrition.In contrast,nutrition interventions are imperative in moderately severe and severe AP.The current article aims to review the latest evidence and suggest practical nutrition interventions in patients with AP,including nutrition requirements,routes of nutrition treatment,types of formula,and the role of nutritional supplements,such as glutamine,probiotics,omega-3 fatty acids,and antioxidants. | Narisorn Lakananurak Leah Gramlich | 2020 | World Journal of Clinical Cases2020，8，9： | 25 |
| 11 | Enteral nutrition and immune modulation of acute pancreatitis显示文摘Enteral nutrition has been strongly recommended by major scientific societies for the nutritional management of patients with acute pancreatitis.Providing severe acute pancreatitis patients with enteral nutrition within the first 24-48 h of hospital admission can help improve outcomes compared to parenteral nutrition and no feeding.New research is focusing in on when and what to feed to best improve outcomes for acute pancreatitis patients.Early enteral nutrition have the potential to modulate the immune responses.Despite this consistent evidence of early enteral nutrition in patients with acute pancreatitis,clinical practice continues to vary due to individual clinician preference.Achieving the immune modulating effects of enteral nutrition heavily depend on proper placement of the feeding tube and managing any tube feeding associated complications.The current article reviews the immune modulating effects of enteral nutrition and pro-and prebiotics and suggests some practical tools that help improve the patient adherence and tolerance to the tube feeding.Proper selection of the type of the tube,close monitoring of the tube for its placement,patency and securing its proper placement and routine checking the gastric residual volume could all help improve the outcome.Using peptide-based and high medium chaintriglycerides feeding formulas help improving feeding tolerance. | Refaat A Hegazi Tiffany De Witt | 2014 | World Journal of Gastroenterology2014，20，43： | 24 |
| 12 | Diet therapy for inflammatory bowel diseases: The established and the new显示文摘Although patients with inflammatory bowel diseases(IBD) have a strong interest in dietary modifications as part of their therapeutic management, dietary advice plays only a minor part in published guidelines. The scientific literature shows that dietary factors might influence the risk of developing IBD, that dysbiosis induced by nutrition contributes to the pathogenesis of IBD, and that diet may serve as a symptomatic treatment for irritable bowel syndrome-like symptoms in IBD. The role of nutrition in IBD is underscored by the effect of various dietary therapies. In paediatric patients with Crohn's disease(CD) enteral nutrition(EN) reaches remission rates similar to steroids. In adult patients, however, EN is inferior to corticosteroids. EN is not effective in ulcerative colitis(UC). Total parenteral nutrition in IBD is not superior to steroids or EN. The use of specific probiotics in patients with IBD can be recommended only in special clinical situations. There is no evidence for efficacy of probiotics in CD. By contrast, studies in UC have shown a beneficial effect in selected patients. For patients with pouchitis, antibiotic treatment followed by probiotics, like VSL#3 or Lactobacillus GG, is effective. When probiotics are used, the risk of bacterial translocation and subsequent bacteremia has to be considered. More understanding of the normal intestinal microflora, and better characterization of probiotic strains at the phenotypic and genomic levels is needed as well as clarification of the mechanisms of action in different clinical settings. A FODMAP reduced diet may improve symptoms in IBD. | Franziska Durchschein Wolfgang Petritsch Heinz F Hammer | 2016 | World Journal of Gastroenterology2016，22，7： | 22 |
| 13 | Implementation of enteral feeding protocol in an intensive care unit: Before-and-after study显示文摘AIM To determine the effects of implementing an enteral feeding protocol on the nutritional delivery and outcomes of intensive care patients.METHODS An uncontrolled, observational before-and-after study was performed in a tertiary mixed medical-surgical intensive care unit(ICU). In 2013, a nurse-driven enteral feeding protocol was developed and implemented in the ICU. Nutrition and outcome-related data from patients who were treated in the study unit from 2011-2012(the Before group) and 2014-2015(the After group) were obtained from a local electronic database, the national Population Registry and the hospital's Infection ControlService. Data from adult patients, readmissions excluded, who were treated for at least 7 d in the study unit were analysed. RESULTS In total, 231 patients were enrolled in the Before and 249 in the After group. The groups were comparable regarding demographics, patient profile, and severity of illness. Fewer patients were mechanically ventilated on admission in the After group(86.7% vs 93.1% in the Before group, P = 0.021). The prevalence of hospitalacquired infections, length of ICU stay and ICU, 30-and 60-d mortality did not differ between the groups. Patients in the After group had a lower 90-d(P = 0.026) and 120-d(P = 0.033) mortality. In the After group, enteral nutrition was prescribed less frequently(P = 0.039) on day 1 but significantly more frequently on all days from day 3. Implementation of the feeding protocol resulted in a higher cumulative amount of enterally(P = 0.049) and a lower cumulative amount of parenterally(P < 0.001) provided calories by day 7, with an overall reduction in caloric provision(P < 0.001). The prevalence of gastrointestinal symptoms was comparable in both groups, as was the frequency of prokinetic use. Underfeeding(total calories < 80% of caloric needs, independent of route) was observed in 59.4% of the study days Before vs 76.9% After(P < 0.001). Inclusion in the Before group, previous abdominal surgery, intraabdominal hypertension and the sum of gastrointestinal symptoms were found to be independent predictors of insufficient enteral nutrition.CONCLUSION The use of a nurse-driven feeding protocol improves the delivery of enteral nutrition in ICU patients without concomitant increases in gastrointestinal symptoms or intra-abdominal hypertension. | Martin Padar Gerli Uusvel Liis Starkopf Joel Starkopf Annika Reintam Blaser | 2017 | World Journal of Critical Care Medicine2017，6，1： | 22 |
| 14 | Management of necrotizing pancreatitis显示文摘Infection complicating pancreatic necrosis leads to persisting sepsis, multiple organ dysfunction syndrome and accounts for about half the deaths that occur following acute pancreatitis. Severe cases due to gallstones require urgent endoscopic sphincterotomy. Patients with pancreatic necrosis should be followed with serial contrast enhanced computed tomography (CE-CT) and if infection is suspected fine needle aspiration of the necrotic area for bacteriology (FNAB) should be undertaken. Treatment of sterile necrosis should initially be non-operative. In the presence of infection necrosectomy is indicated. Although traditionally this has been by open surgery, minimally invasive procedures are a promising new alternative. There are many unresolved issues in the management of pancreatic necrosis. These include, the use of antibiotic prophylaxis, the precise indications for and frequency of repeat CE-CT and FNAB,and the role of enteral feeding. | John Slavin Paula Ghaneh Robert Sutton Mark Hartley Peter Rowlands Conall Garvey Mark Hughes John Neoptolemos | 2001 | World Journal of Gastroenterology2001，7，4： | 21 |
| 15 | Advances in nutritional therapy in inflammatory boweldiseases:Review显示文摘Inflammatory bowel diseases(IBD), including ulcerative colitis and Crohn's disease are chronic, life-long, and relapsing diseases of the gastrointestinal tract. Currently, there are no complete cure possibilities, but combined pharmacological and nutritional therapy may induce remission of the disease. Malnutrition and specific nutritional deficiencies are frequent among IBD patients, so the majority of them need nutritional treatment, which not only improves the state of nutrition of the patients but has strong anti-inflammatory activity as well. Moreover, some nutrients, from early stages of life are suspected as triggering factors in the etiopathogenesis of IBD. Both parenteral and enteral nutrition is used in IBD therapy, but their practical utility in different populations and in different countries is not clearly established, and there are sometimes conflicting theories concerning the role of nutrition in IBD. This review presents the actual data from research studies on the influence of nutrition on the etiopathogenesis of IBD and the latest findings regarding its mechanisms of action. The use of both parenteral and enteral nutrition as therapeutic methods in induction and maintenance therapy in IBD treatment is also extensively discussed. Comparison of the latest research data, scientific theories concerning the role of nutrition in IBD, and different opinions about them are also presented and discussed. Additionally, some potential future perspectives for nutritional therapy are highlighted. | Andrzej Wędrychowicz Andrzej Zając Przemysław Tomasik | 2016 | World Journal of Gastroenterology2016，22，3： | 21 |
| 16 | Fiber and prebiotic supplementation in enteral nutrition:A systematic review and meta-analysis显示文摘AIM:To investigate fiber and prebiotic supplementation of enteral nutrition(EN) for diarrhea,fecal microbiota and short-chain fatty acids(SCFAs).METHODS:MEDLINE,EMBASE,Cochrane Library,CINAHL,Academic Search Premier,and Web of Science databases were searched for human experimental and observational cohort studies conducted between January 1990 and June 2014.The keywords used for the literature search were fiber,prebiotics and enteral nutrition.English language studies with adult patient populations on exclusive EN were selected.Abstracts and/or full texts of selected studies were reviewed and agreed upon by two independent researchers for inclusion in the meta-analysis.Tools used for the quality assessment were Jadad Scale and the Scottish Intercollegiate Guidelines Network Critical Appraisal of the Medical Literature.RESULTS:A total of 456 possible articles were retrieved,and 430 were excluded due to lack of appropriate data.Of the 26 remaining studies,only eight investigated the effects of prebiotics.Results of the meta-analysis indicated that overall,fiber reduces diarrhea in patients receiving EN(OR = 0.47;95%CI:0.29-0.77;P = 0.02).Subgroup analysis revealed a positive effect of fiber supplementation in EN towards diarrhea in stable patients(OR = 0.31;95%CI:0.19-0.51;P < 0.01),but not in critically ill patients(OR = 0.89;95%CI:0.41-1.92;P = 0.77).Prebiotic supplementation in EN does not improve the incidence of diarrhea despite its manipulative effect on bifidobacteria concentrations and SCFA in healthy humans.In addition,the effect of fiber and/or prebiotic supplementation towards fecal microbiota and SCFA remain disputable.CONCLUSION:Fiber helps minimize diarrhea in patients receiving EN,particularly in non-critically ill patients.However,the effect of prebiotics in moderating diarrhea is inconclusive. | Mazuin Kamarul Zaman Kin-Fah Chin Vineya Rai Hazreen Abdul Majid | 2015 | World Journal of Gastroenterology2015，21，17： | 18 |
| 17 | Enteral nutrition and acute pancreatitis显示文摘INTRODUCTIONAcute pancreatitis (AP) is a common severe illness of the digestive tract with variable involvement of other regional tissues and / or remote organ sysems[1-3],Mild disease is associated with minimal organ dysfunction and rapid recovery ,while severe disease is associated with multiple organ system failure and local complications such as necrosis , abscess , fistulas and pseudocyst formation [4-6]. | Qiang Pu Chen Department of Heptobiliary Surgery, The Affiliated Hospital of Binzhou Medical College, Binzhou 256603, Shandong Province, China | 2001 | World Journal of Gastroenterology2001，7，2： | 15 |
| 18 | Use of exclusive enteral nutrition in adults with Crohn's disease: A review显示文摘Exclusive enteral nutrition(EEN)is well-established as a first line therapy instead of corticosteroid(CS)therapy to treat active Crohn’s disease(CD)in children.It also has been shown to have benefits over and above induction of disease remission in paediatric populations.However,other than in Japanese populations,this intervention is not routinely utilised in adults.To investigate potential reasons for variation in response between adult studies of EEN and CS therapy.The Ovid database was searched over a 6-mo period.Articles directly comparing EEN and CS therapy in adults were included.Eleven articles were identified.EEN therapy remission rates varied considerably.Poor compliance with EEN therapy due to unpalatable formula was an issue in half of the studies.Remission rates of studies that only included patients with previously untreated/new CD were higher than studies including patients with both existing and new disease.There was limited evidence to determine if disease location,duration of disease or age of diagnosis affected EEN therapy outcomes.There is some evidence to support the use of EEN as a treatment option for a select group of adults,namely those motivated to adhere to an EEN regimen and possibly those newly diagnosed with CD.In addition,the use of more palatable formulas could improve treatment compliance. | Catherine L Wall Andrew S Day Richard B Gearry | 2013 | World Journal of Gastroenterology2013，19，43： | 15 |
| 19 | Enteral nutrition in treatment of severe acute pancreatitis显示文摘Objective: To observe the role and the timing of EN inthe treatment of patients with severe acute pancreatitis(SAP).Methods: Eleven patients with severe acute pancreatitisunderwent systemic nutrition support were studied.EN was given through jejunostomy tube (or Beng-mark tube) after a period of PN maintenance. ENstarted when serum and urine amylase activity re-turned to normal with regular peristaltic sound, defe-cation or break wind. The sequence of preparationwas as follows: saline glucose→chemically defined di-et→polymeric diet→normal diet.Results: In all the patients, none died. The rate of latecomplications was lower, and the levels of serum albu-min and transferritin significantly increased in thepost-EN period as compared with the pre-EN period,although the count of lymphocytes was less changed.Conclusions: Nutritional support should be trans-formed from PN to EN as early as possible during thetreatment of patients with severe acute pancreatitis. ENcould not only continue sufficient nutritional support,but also avoid the unfavorable effects of long-timePN, thus reducing complications as well as mortality. | Dun Shi Cheng-Wu Zhang Jin-Song Jiang Zhi-Jie Xie Shou-Chun Zou From the Department of General Surgery, Zhejiang Provincial People’s Hospital, Hangzhou 310014, China | 2002 | Hepatobiliary & Pancreatic Diseases International2002，1，1： | 14 |
| 20 | Early enteral nutrition vs parenteral nutrition following pancreaticoduodenectomy: Experience from a single center显示文摘AIM: To analyze and compare postoperative morbidity between patients receiving total parenteral nutrition(TPN) and early enteral nutrition supplemented with parenteral nutrition(EEN + PN).METHODS: Three hundred and forty patients receiving pancreaticoduodenectomy(PD) from 2009 to 2013 at our center were enrolled retrospectively. Patients were divided into two groups depending on postoperative nutrition support scheme: an EEN + PN group(n = 87) and a TPN group(n = 253). Demographic characteristics, comorbidities, preoperative biochemicalparameters, pathological diagnosis, intraoperative information, and postoperative complications of the two groups were analyzed. RESULTS: The two groups did not differ in demographic characteristics, preoperative comorbidities, preoperative biochemical parameters or pathological findings(P > 0.05 for all). However, patients with EEN + PN following PD had a higher incidence of delayed gastric emptying(16.1% vs 6.7%, P = 0.016), pulmonary infection(10.3% vs 3.6%, P = 0.024), and probably intraperitoneal infection(18.4% vs 10.3%, P = 0.059), which might account for their longer nasogastric tube retention time(9 d vs 5 d, P = 0.006), postoperative hospital stay(25 d vs 20 d, P = 0.055) and higher hospitalization expenses(USD10397 vs USD8663.9, P = 0.008), compared to those with TPN.CONCLUSION: Our study suggests that TPN might be safe and sufficient for patient recovery after PD. Postoperative EEN should only be performed scrupulously and selectively. | Jian-Wen Lu Chang Liu Zhao-Qing Du Xue-Min Liu Yi Lv Xu-Feng Zhang | 2016 | World Journal of Gastroenterology2016，22，14： | 11 |
您所在的机构暂未开通此部分的功能，请联系管理员