胰腺积液经皮穿刺引流术精准化治疗的回顾与现状  

Accurate percutaneous catheter drainage treatment for pancreatic fluid collections: a review and current status

作　　者：张劲夫 董春阳 张兴文[1] ZHANG Jinfu;DONG Chunyang;ZHANG Xingwen(Department of Emergency Management,Hunan Provincial People's Hospital/the First Affiliated Hospital of Hunan Normal University,Changsha 410005,China)

机构地区：[1]湖南省人民医院/湖南师范大学第一附属医院急诊科,湖南长沙410005

出　　处：《中国普通外科杂志》2019年第3期350-355,共6页China Journal of General Surgery

基　　金：湖南省人民医院仁术基金资助项目;湖南省卫生厅资助项目(B2014-088);湖南省中医药管理局基金资助项目(201783)

摘　　要：胰腺积液(PFC)是重症急性胰腺炎(SAP)常见的并发症,常导致全身炎症反应综合征(SIRS)、腹内压增高(IAH)、甚至出现难以纠正的腹腔间隙综合征(ACS)进而发展为多器官功能衰竭(MOF)导致患者死亡。随着对SAP病理生理学研究的不断深入及大量循证医学证据的不断涌现,强调微创化、损伤控制的创伤递升式分阶段SAP治疗理念已获得大多数指南性文件的肯定与推崇,但作为起始也是核心的微创方法,超声或CT引导的经皮穿刺引流(PCD)对PFC的穿刺时机、部位仍存在较大争议,如何依据指南又能实现对患者"个体化"、"精准化"治疗,仍需进一步探索。Pancreatic fluid collections (PFC) are common complications of severe acute pancreatitis (SAP).They often cause systemic inflammatory response syndrome (SIRS) and intra-abdominal hypertension (MOF),and even abdominal compartment syndrome (ACS) which is difficult to be corrected,and thereby develop multiple organ failure (MOF) and death.With the deepening of pathophysiological research and emergence of a large number of evidence-based medical data of SAP,the concept of minimally invasive and injury-control staged treatment of SAP has been confirmed and recommended by most guiding documents.However,puncture timing and location of percutaneous catheter drainage (PCD) guided by ultrasound or CT as the initial and core minimally invasive method for PFC are still controversial.How to achieve the “individualized” and “accurate” management of patients according to the guidelines remains to be further explored.

关 键 词：胰腺炎 急性坏死性 渗出液和滤出液 穿刺抽液术 综述文献 

分 类 号：R657.5[医药卫生—外科学]