急性胰腺炎患者的诊治及预后  

Diagnosis, treatment and prognosis of patients with acute pancreatitis

作　　者：刘建[1] 李非[1] 

机构地区：[1]首都医科大学宣武医院普外科,北京100053

出　　处：《中华肝胆外科杂志》2016年第10期714-718,共5页Chinese Journal of Hepatobiliary Surgery

摘　　要：2012年国际胰腺病协会发布了《急性胰腺炎分类一2012：修订后的亚特兰大分类和定义国际共识》，对急性胰腺炎（AP）的诊断、严重程度分型、局部并发症和局部感染做了重新定义。依据修订版亚特兰大标准，重症胰腺炎（SAP）患者构成比显著下降，介于3．7％～25．4％，大多数研究报道〈10．0％。其病死率介于10．0％～52．9％，多数研究显示〉20％。中重症胰腺炎（MSAP）患者构成比介于10．9％～40．1％，病死率介于0～4．8％，器官功能衰竭发生率介于4．6％～34．0％。SAP组ICU住院率、外科干预率和住院时间均显著高于MSAP组。与1992版亚特兰大标准相比，修订版亚特兰大标准能更好地反映患者病情严重程度并指导预后，但它也存在一些缺点，如未能将“局部感染”纳入分型体系等。本文就相关问题进行了综述。Acute Pancreatitis Classification Working Group published Classification of Acute Pancreatitis--2012 ： Re- vision of the Atlanta Classification and Definitions by Interna- tional Consensus in 2012, which redefined the diagnosis, severi- ty, local complication, local infection of acute pancreatitis （AP）. Under the guidance of revised Atlanta classification （RAC）, the constituent ratio of severe acute pancreatitis （SAP） decreases significantly, which is between 3.7% 25.4% , and less than 10.0% is reported in most researches. The mortality of SAP is between 10.0% - 52.9% , and more than 20% is observed in most publications. The constituent ratio of mild severe acute pancreatitis （MSAP） is between 10.9% 40.1% , the mortality is between 0 -4.8% , and the incidence rate of organ failure is between 4.6% - 34.0%. The percentage of patients with SAP who need ICU care and surgery intervention is higher than that of MSAP, and the total hospital stay of SAP are longer than that of MSAP. RAC could better reflect the se- verity and predict the outcome of AP than Atlanta classification published in 1992, but RAC also has some potential limitations. For example, the ＂local infection＂ is not included in this classi- fication. This paper veviewed the relavent issues.

关 键 词：急性胰腺炎 修订版亚特兰大分类 中重症急性胰腺炎 重症胰腺炎 病死率 局部并发症 

分 类 号：R576[医药卫生—消化系统]