摘要
急性胰腺炎(AP)是临床常见的急腹症,欲进一步提高其整体治愈率应将更多精力聚焦于重症急性胰腺炎(SAP)。SAP早期为炎症反应期,应强化ICU内的综合救治,包括充足的液体复苏、早期脏器功能保护、有效的营养支持及腹腔间隔室综合征的处理;而SAP感染期的救治,外科医师应勇于担当,正确把握外科干预的时机,建立以创伤递升式策略为主导、微创化与多学科化相结合的多元化清创模式。此外,还应重视SAP后期并发症,防患于未然。SAP整个救治过程均应以多学科团队为依托,各个科室间应通力合作,建立各层面的医联体,必要时及时进行网络会诊或转诊,从而降低SAP病死率,提高AP整体治愈率,使患者最大程度受益。
Acute pancreatitis (AP) is a common clinical acute abdominal disease. To further improve its overall cure rate, severe acute pancreatitis (SAP) should be paid more attention.In early inflammatory reaction period of SAP, comprehensive treatment in ICU should be strengthened, including adequate fluid resuscitation, early viscera function protection, effective nutritional support and dealing with abdominal compartment syndrome. Surgeons should be responsible in the treatment of infection period of SAP, and seize the timing of surgical intervention correctly. Pluralistic debridement model should be set up, which is mainly based on "step-up" strategy and combined with minimally invasive and multi-disciplinary. In addition,late complications of SAP should be prevented and treated with caution when they occur. The whole SAP treatment system should be based on the multi-disciplinary team (MDT), which requires fully cooperation of each department. Moreover, medical unions at different levels should be established to realize prompt network consultation or referral. In this way, case fatality rate of SAP can be reduced and overall cure rate of AP can be improved, thus benefiting the patients to the maximum extent.
作者
孙备
张广权
Sun Bei;Zhang Guangquan(Department of Pancreatic and Biliary Surgery,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2018年第12期1160-1165,共6页
Chinese Journal of Digestive Surgery
基金
国家自然科学基金(81670583、81770639).
