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重症急性胰腺炎治疗焦点的转移
杜奕奇*
0
(海军军医大学(第二军医大学)长海医院消化内科, 上海 200433
*通信作者)
摘要:
重症急性胰腺炎是消化系统常见的危重急症,临床救治难度大,病死率高。根据2012年亚特兰大新分类标准,临床上将急性胰腺炎的治疗重点聚焦于早期识别、脏器功能的维持、抗炎性反应、肠道功能维护等措施,显著提高了救治成功率。随着更多重症急性胰腺炎患者成功度过急性期,其后期并发症的防治日益受到重视。围绕急性胰腺炎的"二次打击",有必要开展针对胰周液体积聚、感染性坏死、血管并发症等后期并发症的临床研究,进一步降低后期病死率。这是急性胰腺炎治疗焦点的再次转变,也是急性胰腺炎多学科协作理念的进一步延伸。
关键词:  重症急性胰腺炎  治疗  焦点  并发症  多学科协作
DOI:10.16781/j.0258-879x.2018.03.0233
投稿时间:2017-11-06修订日期:2018-01-15
基金项目:
Switch of focus on treatment of severe acute pancreatitis
DU Yi-qi*
(Department of Gastroenterology, Changhai Hospital, Navy Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Severe acute pancreatitis is a common critical emergency in the digestive system. It is difficult to treat in clinic and has high mortality. According to the new Atlanta classification standard proposed in 2012, the treatment of acute pancreatitis mainly focused on early indentification, maintenance of organ function, anti-inflammatory response, intestinal function maintenance and other measures, so as to improve the success rate of the treatment. As more patients with severe acute pancreatitis have successfully crossed the acute phase, the prevention and treatment of subsequent complications of acute pancreatitis have been increasingly valued. To focus on the "secondary attack" of acute pancreatitis, it is necessary to carry out clinical research on the subsequent complications such as the accumulation of peripancreatic fluid, infectious necrosis, and vascular complications, and to reduce the mortality. This is a change in the focus of acute pancreatitis treatment and a further extension of the concept of multidisciplinary collaboration in acute pancreatitis.
Key words:  severe acute pancreatitis  treatment  focus  complication  multidisciplinary collaboration