重症急性胰腺炎合并感染性胰腺坏死1例并文献复习  

Severe acute pancreatitis with infected pancreatic necrosis:A case report and literature review

作　　者：郑文豪 杨彦 梁昌富 王溢萌 Zheng Wenhao;Yang Yan;Liang Changfu;Wang Yimeng(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Hainan Medical University,Hainan Haikou 570100,China;Department of Emergency and Trauma Surgery,the First Affiliated Hospital of Hainan Medical University,Hainan Haikou 570100,China;The Hainan Branch of National Clinical Research Center for Cancer&The First Affiliated Hospital of Hainan Medical University,Hainan Haikou 570102,China)

机构地区：[1]海南医科大学第一附属医院肝胆外科,海南海口570100 [2]海南医科大学第一附属医院急诊与创伤外科,海南海口570100 [3]海南医科大学第一附属医院,国家恶性肿瘤临床医学研究中心海南分中心,海南海口570102

出　　处：《腹部外科》2025年第2期142-146,共5页Journal of Abdominal Surgery

基　　金：国家自然科学基金项目(81860514)。

摘　　要：重症急性胰腺炎病人病情发展迅速,病程凶险,并发症发生率高,预后较差。感染性胰腺坏死是重症急性胰腺炎的常见并发症之一,大约20%的重症急性胰腺炎病人会发生胰腺或胰周的坏死,死亡率从8%到39%不等。由于诊断方法有限,感染性胰腺坏死的早期诊断删除困难,且在治疗策略和治疗时机上一直存在争议,目前以“Step-up”策略为主。该文报道了1例病情反复、住院时间较长的感染性胰腺坏死病人的诊疗过程,结合海南医科大学第一附属医院诊疗经验并复习国内外相关文献,对该疾病的病因、发病机制、早期诊断及治疗等方面进行归纳和总结,以便提高临床医师对该疾病的认识,为临床工作提供借鉴。Severe acute pancreatitis develops rapidly and extremely dangerous,with a high incidence of complications,and poor prognosis.Infected pancreatic necrosis(IPN)is one of the complications of severe pancreatitis.Approximately 20%of severe acute pancreatitis patients develop pancreatic or peripancreatic necrosis,with a mortality rate ranging from 8%to 39%.Early diagnosis of IPN remains challenging due to limited diagnostic methods,and controversies persist regarding optimal treatment strategies and timing.So far,a"step-up"strategy is the main strategy for treating IPN.This paper reported the diagnosis and treatment of an adult male IPN patient with repeated courses and long hospital stay.Based on our clinical experience and literature review at home and abroad,we introduced and summarized the etiology,pathogenesis,early diagnosis,and treatment of IPN,in order to enhance clinicians'understanding and provide practical guidance for clinical practice.

关 键 词：重症急性胰腺炎 感染性胰腺坏死 文献复习 

分 类 号：R657.5[医药卫生—外科学]