摘要
重症急性胰腺炎(SAP)病情发展迅速,病情凶险,且并发症多,死亡率较高,治疗极为棘手,发病率约占急性胰腺炎的20%,是常见的外科急腹症。随着对重症急性胰腺炎治疗研究的不断深入,微创化治疗SAP的理念已广泛应用于临床,其使SAP治愈率不断提高,大大降低了病死率。虽然微创化治疗SAP技术在不断的进步与完善,但在SAP治疗的过程中诸多细节问题尚无统一标准,对于胰腺和或胰腺周围组织感染行经皮穿刺置管引流术(PCD),已基本达成一致。但对于SAP早期合并的胰腺炎相关性腹水,是否早期行腹腔穿刺置管引流(APD),尚存在争议。同时对于伴有大量腹腔积液的SAP患者早期完善腹腔穿刺置管引流,众多相关文献均强调需在SAP早期行腹腔穿刺引流,但其最佳时机目前尚未达成共识,仍需进一步的探索与完善。本文讨论关于重症急性胰腺炎腹腔穿刺引流的时机与疗效研究进展。
Severe acute pancreatitis(SAP)is featured in rapid development,extremely dangerous conditions,a great number of complications,high mortality,and extremely tough treatment.It accounts for about 20%among acute pancreatitis,so that it is actually a common surgical acute abdominal disease.With the in-depth research on the treatment of severe acute pancreatitis,the concept of minimally invasive SAP treatment has been widely applied in clinics,which continuously improves the SAP survival rate and greatly reduces the mortality rate.Although the minimally invasive SAP treatment has been constantly advanced and optimized,there still lack unified standard for a lot of detailed problems appeared in SAP treatment process.The percutaneous catheter drainage(PCD)technology has been recognized and reached consensus on the treatment of pancreatic and or surrounding tissue infections.But for pancreatitis-related ascites in the early stage of SAP,it is still in dispute of whether or not to perform abdominal puncture drainage(APD)in early stage.Meanwhile,for SAP patients with a lot of abdominal effusion,the performance of intraperitoneal percutaneous drainage in early stage has been confirmed in a great number of literature.But no consensus about the best timing has been reached up to now,which needs to be further explored and optimized.In this paper,the timing and efficacy of abdominal puncture drainage for severe acute pancreatitis treatment were studied.
作者
王远发
李航
孙宝震
季德刚
Wang Yuanfa;Li Hang;Sun Baozhen;Ji Degang(Department of Hepatopancreatobiliary Surgery,China-Japan Union Hospital of Jilin University,Changchun 130031,China)
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2020年第8期1584-1586,共3页
Chinese Journal of Experimental Surgery
关键词
重症急性胰腺炎
微创化治疗
穿刺引流
穿刺时机
胰源性腹水
Severe acute pancreatitis
Minimally invasive treatment
Puncture drainage
Puncture timing
Pancreatic ascites
