强血性胰腺炎:诊断,治疗和预后
Li-Jun Cao1, Zhong-Hua Lu1, Pin-Jie Zhang1
1The First Department of Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China.
腹性胰腺炎 (EP) 是一种严重的疾病,死亡率高. 早期诊断和通过皮肤排水等干预措施可以改善结果,而积极的抗菌药物治疗至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 密集护理医学 密集护理医学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 囊性胰腺炎 (EP) 是一种罕见的,严重的瘤性胰腺炎变体.
- 由于胰腺/胰周组织中存在气体,EP的死亡率很高.
研究的目的:
- 为了评估诊断,治疗策略和患者在缩性胰腺炎的结果.
- 本病例系列旨在确定影响EP患者预后的因素.
主要方法:
- 追溯15名患者的病例系列,通过CT诊断出胰腺缩和气体.
- 根据气体的存在和分布,患者被分为早期/晚期发病和广泛/常见类型.
- 数据包括人口统计,病因,严重程度得分,干预措施和结果.
主要成果:
- 胆道病因和广泛的EP是常见的 (66.7%). 早期发病的EP发生在47.1%的患者中.
- 大肠杆菌 (Escherichia coli) 和肺炎菌 (Klebsiella pneumoniae) 是常见的病原体. 下一代测序 (NGS) 改进了识别.
- 根据干预措施的生存率有所不同:没有排水/手术的生存率为1/2,通过皮肤排水的生存率为4/6,仅通过手术的生存率为1/6.
结论:
- 腹性胰腺炎带有相当大的死亡率.
- 下一代测序 (NGS) 提高了病原体识别的准确性.
- 涉及积极的抗微生物药物,早期皮肤疏通和延迟手术的策略可能会改善预后.
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