感染性胰腺坏死的外科诊治  

Surgical management and treatment of infected pancreatic necrosis

作　　者：李非[1,2] 黄铂涵 LI Fei;HUANG Bohan(Department of General Surgery,Xuanwu Hospital Capital Medical University,Beijing 100053,China;Clinical Center for Acute Pancreatitis,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院普通外科,北京100053 [2]首都医科大学急性胰腺炎临床诊疗与研究中心,北京100053

出　　处：《中国普通外科杂志》2024年第9期1385-1391,共7页China Journal of General Surgery

基　　金：北京科技计划基金资助项目(Z201100005520090)。

摘　　要：急性胰腺炎是消化系统常见的急腹症之一,且其发病率有逐年上升的趋势。尽管约80%的病例为不伴有局部并发症的轻症患者,但仍有部分患者在病程后期出现胰腺假性囊肿、包裹性坏死等局部并发症,其中以感染性胰腺坏死(IPN)最为严重,病死率可达30%。近年来,以微创外科为核心的治疗方式取得了较好疗效;最新的几项临床试验亦为IPN的外科诊治提供了实质性的新见解。但值得注意的是,IPN具有个体差异大、治疗过程复杂等特点。因此,有必要讨论IPN的外科治疗策略,为临床医师在进行相关处理时提供一定的参考。Acute pancreatitis is one of the common acute abdominal conditions in the digestive system,and its incidence is on the rise.Although approximately 80%of cases involve mild patients without local complications,some patients develop local complications in the later stages of the disease,such as pancreatic pseudocysts and walled-off necrosis.Among these,infected pancreatic necrosis(IPN)is the most severe,with a mortality rate of up to 30%.In recent years,treatment approaches centered around minimally invasive surgery have achieved promising results;several recent clinical trials have also provided substantial new insights into the surgical diagnosis and treatment of IPN.However,it is worth noting that IPN exhibits considerable individual variability and complex treatment processes.Therefore,it is necessary to discuss surgical treatment strategies for IPN to offer clinical practitioners a reference for relevant management.

关 键 词：胰腺炎 急性坏死性 继发感染 外科手术 

分 类 号：R657.5[医药卫生—外科学]