早期预测和预防受感染的胰腺亡
Cheng Lv1, Zi-Xiong Zhang1, Lu Ke1,2
1Department of Critical Care Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210000, Jiangsu Province, China.
World journal of gastroenterology
|April 5, 2024
概括
识别患有感染性胰腺亡 (IPN) 高风险的患者对于早期干预至关重要. 虽然存在预测标志物和评分系统,但除了早期肠道营养之外,仍然需要有效的IPN预防策略.
科学领域:
- 胃肠病学和肝病学
- 手术重症监护手术重症监护
背景情况:
- 感染性胰腺亡 (IPN) 复杂化了20%-30%的急性亡性胰腺炎病例,显著增加了发病率和死亡率.
- 早期识别高风险患者对于实施预防策略和改善结果至关重要.
- 不同的传统和新型生物标志物,以及已建立的评分系统,已经证明与IPN发展有关联.
研究的目的:
- 审查有关感染性胰腺瘤 (IPN) 早期预测和预防策略的现有证据.
- 为未来的研究方向和管理IPN风险的临床实践提供见解.
主要方法:
- 关于与IPN相关的传统和新生物标志物的文献综述.
- 对IPN预测准确性建立的评分系统 (APACHE II,PANS) 的评估.
- 治疗干预措施的分析,包括肠道营养,抗生素和免疫调节.
主要成果:
- 几种生物标志物 (CRP,PCT,IL-6,IL-8,Ang-2) 和评分系统在预测IPN方面表现出显著的关联性和准确性.
- 早期肠道营养有希望,但其他预防疗法 (抗生素,益生菌) 的结果是可变的.
- 减少IPN发生率的有效治疗方法仍然有限.
结论:
- 基于证据的预测标记和评分系统可用于早期IPN风险分层.
- 早期肠道营养是关键的预防措施,但对其他干预措施需要进一步研究.
- 未来的研究需要同质的患者群体和可靠的风险分层来开发有效的,个性化的IPN治疗.
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