肾脏替代疗法治疗重症急性胰腺炎的启动时机  

Timing of initiation of renal replacement therapy for severe acute pancreatitis

作　　者：李明霞 赵双平[1,2,3] LI Mingxia;ZHAO Shuangping(Department of Critical Care Medicine,Xiangya Hospital Central South University,Changsha,Hunan 410008,P.R.China;National Clinical Research Center for Geriatric Disorders,Changsha,Hunan 410008,P.R.China;Hunan Provincial Clinical Research Center of Intensive Care Medicine,Changsha,Hunan 410008,P.R.China)

机构地区：[1]中南大学湘雅医院重症医学科,长沙410008 [2]国家老年疾病临床研究中心,长沙410008 [3]湖南省重症医学临床研究中心,长沙410008

出　　处：《华西医学》2022年第7期979-983,共5页West China Medical Journal

基　　金：湖南省卫生健康委科研项目(202217015418)。

摘　　要：重症急性胰腺炎(severe acute pancreatitis,SAP)是一种常合并全身多器官功能障碍的重症急性炎症性疾病,其发病机制复杂、病情发展快、病死率高、治疗方案复杂、社会经济负担重。由于肾脏替代疗法(renal replacement therapy,RRT)在清除炎症介质、细胞因子等毒素以及稳定内环境方面发挥着重要作用,因此,RRT作为一种器官支持技术可用于SAP的临床管理。目前关于SAP何时以及何种情况下应用RRT尚未达成共识。该文将对SAP的发病机制以及RRT干预的适应证和启动时机进行逐一阐述。Severe acute pancreatitis(SAP)is a serious acute inflammatory disease with complex pathogenesis,rapid progression,high mortality,extensive treatment,and heavy socioeconomic burden,which is often complicated by systemic multiple organ dysfunction.Renal replacement therapy(RRT)is essential for removing inflammatory mediators,cytokines or other toxins,as well as stabilizing the internal environment.Therefore,RRT is utilized as an organ support technology in the clinical management of SAP.Currently,there is no consensus regarding when and under what circumstances RRT can be employed in patients with SAP.In this paper,the pathogenesis of SAP and the indications and timing of initiation of RRT will be discussed.

关 键 词：重症急性胰腺炎 肾脏替代疗法 启动时机 

分 类 号：R576[医药卫生—消化系统]