急性胰腺炎的逐步管理:来自印度南部的第三级护理中心的经验
Joel Kumar Earjala1, Thiruvarul Muthukumarasamy1, Senthil Kumaran Govindaraj Raman1
1Surgical Gastroenterology and GI Oncology, Thanjavur Medical College, Thanjavur, IND.
Cureus
|May 27, 2024
概括
阶段性方法,包括穿皮排水,有效地管理急性胰腺炎 (AP). 然而,晚期出现的严重AP病例的死亡率仍然很高,强调需要标准化管理协议.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 外科胃肠道外科手术
背景情况:
- 急性胰腺炎 (AP) 具有广泛的临床谱,从轻度到严重的多器官衰竭形式.
- 急性瘤性胰腺炎 (ANP) 是AP的严重表现.
- 有效的管理策略对于改善AP的结果至关重要.
研究的目的:
- 以逐步方法评估急性胰腺炎 (AP) 管理的结果.
- 评估皮肤间排水作为AP的初始治疗的安全性和有效性.
- 确定严重AP病例中与死亡率相关的因素.
主要方法:
- 在两年内 (2021年1月 - 2022年12月) 进行的前性观察研究.
- 包括急性胰腺炎 (AP) 患者入院到三级医疗保健中心的患者.
- 逐步管理原则的应用,包括图像引导的皮肤穿透排水和死体切除术.
主要成果:
- 研究了90名患有AP的患者;乙醇是常见的病因.
- 41.1%的人患有轻度AP,27.7%的中度严重,31.1%的严重AP.
- 在入院时,40%的患者出现了器官衰竭;25.5%的患者出现了ANP.
- 20%的患者需要通过皮肤排水,其中38.8%的患者进行了体切除术.
- 总体死亡率为8.8%,较晚出现的患者的死亡率更高 (6.6%).
结论:
- 穿皮导管排水是AP的安全有效的初始治疗方法,在需要时将其连接到切除术.
- 晚期出现的严重AP病例与显著的死亡率有关,尽管进行了逐步管理.
- 标准化的转诊和管理协议对于AP的最佳临床结果至关重要.
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