［Abstract］ Objectives: To explore the effect of the combined application of total parenteral nutrition(TPN)and enteral nutrition (EN) in severe acute pancreatitis（SAP）. Methods One hundred and twenty-six patients with SAP were randomized either to treat with TPN support(TPN group, n=42)or with EN support(EN group, n=42) and with TPN+ EN support(TPN+ EN group, n=42) ,Peptisorb type of enteral nutrition were chosen during the jejunal nutrition ，The chang of clin data were observed. Results During observation, APACHE-Ⅱ scores, Ranson score, the curative rate, the mortality rate and the nutritional state of body There were no significantly differences in 3 group befere nutritional support（P>0.05）. The incidences of complications and the average hospital stay significantly decreased in TPN+EN group after treatment compared with TPN group and EN group. The incidences of complications were significantly lower than those in EN group after treatment Compared with TPN（P<0.05）. Conclusions: The combined application of total parenteral nutrition(TPN)and enteral nutrition (EN) can effectively reduced the incidences of complications, the average hospital stay and improve the nutrition conditions in （SAP）.Therefore ,it provides the most reasonable way in nutrition therapy of SAP.