急性胰腺炎:一个回顾
Michael A Mederos1, Howard A Reber1, Mark D Girgis1
1Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California.
JAMA
|January 26, 2021
概括
急性胰腺炎的治疗包括风险分层,液体复苏和营养支持. 早期干预和降低风险的策略可以改善患者的治疗结果并减少并发症.
科学领域:
- 胃肠病学
- 内部医学
- 危急护理医学
背景情况:
- 急性胰腺炎是美国住院的常见原因,患病率和死亡率很高.
- 有效管理需要了解疾病的严重程度并及时实施干预措施.
研究的目的:
- 对急性胰腺炎管理的现有建议进行审查.
- 强调风险分层,流体和营养支持以及后续护理的重要性.
主要方法:
- 对MEDLINE和Cochrane数据库进行系统的文献搜索 (2009-2020年).
- 专注于预测评分工具,流体管理,营养和降低风险的策略.
主要成果:
- 评分系统 (BISAP,APACHE II) 有助于预测严重程度,但需要临床相关性.
- 早期,积极的液体复苏和肠道营养与降低死亡率和传染性并发症有关.
- 确定病因和实施降低风险的策略 (如胆囊切除术,戒酒) 是至关重要的.
结论:
- 急性胰腺炎是复杂的,严重程度会影响治疗.
- 及时诊断和严重程度分层是关键.
- 临床判断应指导使用评分系统;流体和营养管理是护理的关键组成部分.
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