重症急性胰腺炎治疗焦点的转移

【】重症急性胰腺炎(Severe acute pancreatitis,SAP)是消化系统常见的危重急症,临床救治难度大,病死率高。随着近年来亚特兰大新分类标准的提出,急性胰腺炎的治疗重点聚焦于早期脏器功能的支持、抗炎症反应、肠道功能维护等措施,使救治成功率有显著提高。随着更多的SAP患者成功度过急性期,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,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(MDT)理念的进一步延伸。

Switch of focus on treatment of severe acute pancreatitis

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.