胰腺炎营养治疗国际共识指南-guo-2012.6

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1、InternationalConsensusGuidelinesforNutritionTherapyinPancreatitis胰腺炎营养治疗国际共识指南Apr24,2012VersionofRecordMar28,2012OnlineFirstVersionofRecord•Platinum(A):guidelinestatementmeetingthecriteriaforhighgradeofevidencewithuniformconsensusacrossmultiplesocietalreports白金（A）：指南建议符合如下标准，具有高水平证据

2、支持并且多个协会指南意见相一致••Gold(B):guidelinestatementthatmeetscriteriaforlow/intermediategradeofevidenceorwherethereislackofconsensusacrosssocietalreports(atleast1societalreportisindisagreement)黄金（B）：指南建议符合如下标准，中低水平证据支持，或者协会指南之间缺乏共识（至少一个协会指南建议不一致）••Silver(C):guidelinestatementmeetingthecriter

3、iaforhighgradeofevidence,publishedonlyinasinglesocietalreport(consensusnotapplicableinthiscase)白银（C）：指南建议符合如下标准，仅有一个协会发布的具有高水平证据支持的建议（共识不适用于此等情况）Table4.FinalGradeofRecommendationforInternationalConsensusGuidelinesInternationalGuidelinesRecommendations—GradeCategorizationGradeofRecom

4、mendationNumberofSocietiesStrengthofEvidenceConsensusAgreementA(platinum)MultiplesocietiesHighlevelofevidenceConsensusB(gold)MultiplesocietiesIntermediatetolowlevelofevidenceLackofconsensusC(silver)SinglesocietyHighlevelofevidenceNA（notapplicable）IndicationforNutritionTherapy营养治疗指征1

5、.Pancreatitispatientsareatnutritionriskandshouldbescreened.(GradeB:Gold)1.胰腺炎患者存在营养风险，应当进行营养筛查。(GradeB:Gold)2.Formildtomoderatedisease,analgesics,intravenous(IV)fluids,andnilperos(NPO)withagradualadvancementtodiet(usuallywithin3–4days)arerecommended.(GradeC:Silver)2.对于轻中度患者，推荐镇痛剂、静脉

6、补液、从开始禁食（NPO）逐渐过渡到日常饮食（一般3-4天）。(GradeC:Silver)Theneedfornutritiontherapy(NT)bytheenteralorparenteralrouteshouldbebasedontheextentofdiseaseandnutritionstatusofthepatient.根据疾病严重程度和患者营养状态判断是否需要肠内或肠外营养治疗（NT）。3.NTisnotgenerallyneededformildtomoderatediseaseunlesscomplicationsensue.(Grade

7、A:Platinum)3.轻中度胰腺炎一般无需NT，除非并发症出现。(GradeA:Platinum)4.NTshouldbeconsideredinanypatientregardlessofdiseaseseverityiftheanticipateddurationofbeingNPOis>5–7days.(GradeB:Gold)4.预期禁食时间超过5-7天应当考虑NT，无需考虑疾病严重程度。(GradeA:Platinum)5.NTisneededinmildtomoderatediseasewhenthepatienthasbeenNPOfor5–

8、7days.(GradeB:Gold)