摘要
早期重症急性胰腺炎（SAP）胰腺局部产生的大量炎症因子、血管活性物质和有毒物质溢人循环，引发全身性炎症反应综合征（SIRS）。微血管损伤、微循环障碍以及出凝血机制异常明显增加毛细血管的通透性，使更多的血浆成分和组织液丢失，甚至出现全身毛细血管渗漏综合征（CLS）。因此，缓解血浆和组织液严重丢失是SAP早期急救治疗的关键，从而防治多器官功能衰竭（MOF）。为尽早恢复组织细胞生存代谢的微循环系统，应强调应用高渗NaCl溶液、低分子右旋糖酐、血浆或一些新型胶体复苏液实施合理的液体复苏。当然，只有综合采用液体复苏以及血液净化、高压氧疗等方法才可能获得SAP早期急救的成功。
In early stage of severe acute pancreatitis （SAP）, large amount of inflammatory factors, vasoactive substances and toxic substances produced locally spilled from pancreas into circulation, followed by occurrence of systemic inflammatory response syndrome （SIRS）. Large amount of plasma and interstitial fluid are lost due to increased capillary permeability resulting from capillary damage, microcirculatory disturbance and abnormal coagulation, which is called capillary leakage syndrome （CLS）. Only with rapid recovery of lost plasma and interstitial fluid, a key issue in emergent management of SAP, can multiple organ failure （MOF） be prevented. In order to restore microcirculation for the survival of cells and organs, fluid resuscitation is employed using hypertonic saline, low molecular dextran, plasma or some new colloidal fluid. Besides fluid resuscitation, blood purification and hyperbaric oxygen therapy are all among the rescue attempts in the early management of SAP.
出处
《胃肠病学》
2010年第1期42-45,共4页
Chinese Journal of Gastroenterology
关键词
重症急性胰腺炎
液体复苏
血容量不足
微循环
治疗
Severe Acute Pancreatitis
Fluid Resuscitation
Hypovolemia
Microcirculation
Therapy
