重症急性胰腺炎外科救援的实施与策略
Implementation and strategy of surgical rescue in the treatment of severe acute pancreatitis
孙备 1白睿 1隋宇航1
作者信息
- 1. 哈尔滨医科大学附属第一医院胰胆外科肝脾外科教育部重点实验室,哈尔滨 150001
- 折叠
摘要
重症急性胰腺炎(SAP)的临床治疗经历从激进手术到保守治疗,再到如今微创与开放相结合的多学科综合治疗模式的转变.SAP患者病情复杂且进展迅猛,个体差异较大,部分患者会发生消化道瘘、严重腹腔感染、大出血、腹腔间隔室综合征、重症胆囊并发症等外科急危重症,保守治疗收效甚微,常需果断采取外科救援以挽救生命.笔者结合临床实践和最新文献,首次将外科救援概念引入SAP救治中,阐述SAP病程中外科救援策略与不同情境下外科救援要点,并对如何提高外科救援成功率提出个人见解,旨在进一步提高SAP整体治愈率.
Abstract
The development of treatment of severe acute pancreatitis(SAP)has gone through a dramatic transformation from radical surgery to conservative treatment,and now to a multidisciplinary comprehensive diagnosis and treatment model which combines minimally invasive and open surgery.Due to the complexity,rapid progression,and significantly individual differences,some patients of SAP may experience surgical emergencies such as gastrointestinal fistula,severe abdominal infection,massive bleeding,abdominal compartment syndrome,and severe biliary system complications.Conservative treatment has little effect and often requires decisive surgical rescue to potentially save the patients'lives.Based on clinical practice and the latest literature,the authors introduce the concept of surgical rescue into the treatment of SAP for the first time,in order to explain the strategies of surgical rescue in the SAP disease process and the key points of implemen-ting surgical rescue in different situations,and to provide personal insights on how to improve the success rate of surgical rescue for further improving the overall cure rate of SAP.
关键词
重症急性胰腺炎/感染性胰腺坏死/并发症/外科救援/策略Key words
Severe acute pancreatitis/Infected pancreatic necrosis/Complication/Sur-gical rescue/Strategy引用本文复制引用
基金项目
国家自然科学基金(82070658)
国家自然科学基金(82270665)
黑龙江省自然科学基金团队项目(TD2021H001)
出版年
2024
NETL
NSTL
万方数据