关键词: 急性胰腺炎；营养支持；肠内营养；证据总结

Abstract: Objective: To evaluate and integrate evidence of nutritional support pathways and timing of enteral nutrition treatment, route of enteral feeding and nutrition supplements in patients with acute pancreatitis. Methods: Cochrane Library, PubMed, Embase, CINAHL, medlive, CNKI, WanFang Data, GIN, NICE, SIGN, JBI Library, RNAO were searched. The Evidence and Grades of Recommendation system of the Australian JBI Evidence-Based Health Care Center and Appraisal Guidelines for Research and Evaluation (AGREE II) were used to evaluate the quality of included studies. Results: A total of 538 studies were retrieved. After removing the duplicates and checking the inclusion and exclusion criteria, 11 guidelines were included. This study summarized 16 pieces of evidence of nutritional support in patients with acute pancreatitis, including nutritional support pathways, timing of enteral nutrition treatment, route of enteral feeding, and nutrition supplements. For patients with mild acute pancreatitis, it is recommended to take oral nutrition as early as possible. If oral nutrition is not tolerated, it is recommended to provide enteral nutrition first. Only when enteral nutrition fails or is contraindicated, total parenteral nutrition is considered to be given. In terms of dietary choices, patients with mild acute pancreatitis are not limited to clear liquid diets, and can be given low-fat or normal-fat soft or solid diets according to their preferences. In patients with moderate to severe acute pancreatitis, it is recommended to start enteral nutrition with standard polymeric formula after adequate fluid resuscitation. While evidence on semi-elemental, elemental formulations, immune-enhancing preparations, probiotics, fiber formulations, and ω-3 fatty acids is limited, and should be reconsidered carefully based on patients’ clinical condition. Conclusion: Through multidisciplinary teamwork, providing nutritional support at the right time and in an appropriate manner can reduce the intensity and duration of abdominal pain in patients with acute pancreatitis, and shorten hospital length of staying. It can also reduce infection complications and mortality, improve the patient's satisfaction and the clinical nursing quality.

Key words: acute pancreatitis; nutritional support; enteral nutrition; evidence summary