感染性胰腺坏死的治疗进展  

Treatment progress of infected pancreatic necrosis

作　　者：杜越晨 倪建波(综述)[1] 万荣(审校)[1] DU Yue-chen;NI Jian-bo;WAN Rong(Dept.of Gastroenterology,Shanghai General Hospital,Shanghai Jiao Tong University,Shanghai 200080,China)

机构地区：[1]上海交通大学附属第一人民医院消化科,上海200080

出　　处：《同济大学学报（医学版）》2020年第6期796-800,共5页Journal of Tongji University(Medical Science)

基　　金：国家自然科学基金(81400663、81802318);上海市卫生和计划生育委员会项目(ZY(2018—2020)-FWTX-1004)。

摘　　要：急性胰腺炎是一种内科常见急症,胰腺坏死并发感染可导致严重脓毒血症甚至多器官功能衰竭。近年来,随着消化内外科微创手术水平的快速提高,微创升阶梯理念已逐渐代替外科清创,成为胰腺感染性坏死(infected pancreatic necrosis,IPN)的首选治疗策略。本文对超声内镜下穿刺引流内镜下经腔坏死切除术LAMS支架置入+鼻胆管引流的消化内镜下升阶梯治疗策略的有效性、安全性以及内镜下操作细节等作一详细综述,对内镜升阶梯治疗与外科微创升阶梯治疗策略的各自优势进行阐述,为IPN临床治疗策略的选择提供理论指导。Acute pancreatitis is a common gastrointestinal disorder.Infected pancreatic necrosis(IPN)can result in severe sepsis and eventually multiple organ failure(MODS).In recent years,the minimally invasive step-up approach has gradually replaced surgical debridement and become the preferred treatment choice for IPN.This review summarized the effectiveness,safety and procedure details of the minimally invasive step-up approach for IPN,including ultrasound-guided endoscopic transluminal drainage,endoscopic transluminal necrossectomy,lumen-apposing metal stents implantation and nasobiliary drainage based on the relevant literature;and also elaborates the advantages of minimally invasive and endoscopic step-up approach to provide information for clinical treatment of IPN.

关 键 词：感染性胰腺坏死 内镜下坏死清除术 升阶梯治疗 

分 类 号：R576[医药卫生—消化系统]