重症急性胰腺炎诊治进展

急性胰腺炎作为常见的外科急腹症之一,重症急性胰腺炎占其中15%-20%（severe acute pancreatitis,SAP）,其病情笃重,合并症多,病程进展迅速,病死率高,近年来对于重症胰腺炎在诊断、重症监护、手术策略、综合治疗等方面都取得了长足进展,但对于重症急性胰腺炎的发病机理及病程演变过程的深入研究机理未完全明了,临床治疗上仍存在较多争议。现阶段较公认的治疗是病变早期以非手术治疗为主,后期出现继发感染后采用手术治疗的＂个体化治疗方案＂和＂综合治疗体系＂,使SAP的生存率达到了70%-80%。但是,即使在大的胰腺炎治疗中心,病死率仍然高达10%~20%。文章就近年来SAP的诊治新进展、新观念做一综述。

Diagnosis and Treatment of Severe Acute Pancreatitis

The abstract acute pancreatitis take one of common surgical department acute abdominal pains.The critically ill acute pancreatitis occupy 15%~20%（severe acute pancreatitis,SAP）,its condition sincere heavy,the complications are many,the course progress is rapid,the case fatality rate is high,Regarding the critically ill pancreatitis in the diagnosis,the critically ill guardianship,the surgery strategy,aspects and so on complex therapy has made in recent years the considerable progress,The clinical care still existed disputed much.The present stage recognizes the treatment is treats by the pathological change early time by the non-surgery primarily.Later period appears after sending the infection uses the surgery to treat ＂the individuation therapeutic schedule＂and＂the synthesis Taiwan treatment system＂,enabled SAP the survival rate to achieve 70%~80%.But,even if treats the center at the big pancreatitis,the case fatality rate still reached as high as 10%~20%.This article on the recent years SAP diagnosis new progress,the new idea made a summary.