对急性瘤性胰腺炎的多学科方法
Dana Ben-Ami Shor1, Einat Ritter1, Tom Borkovsky1
1Department of Gastroenterology, Tel-Aviv Sourasky Medical Center, Affiliated to the Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel.
Journal of clinical medicine
|May 14, 2025
概括
严重的急性胰腺炎,通常是由胆结石或酒精引起的,可能导致器官衰竭. 治疗包括支持性护理,抗生素和干预措施,如内镜超声波 (EUS) 引导的感染液体收集的排水.
科学领域:
- 胃肠病学 胃肠病学
- 内部医学 内部医学
- 外科胃肠道外科手术
背景情况:
- 急性胰腺炎是一种常见的胃肠道疾病,胆结石和滥用酒精是主要的触发因素.
- 虽然通常是轻微的,但严重的病例 (高达20%) 涉及胰腺缩,导致多器官衰竭和增加死亡率.
- 管理策略范围从保守护理到对并发症的侵入性干预.
研究的目的:
- 概述急性胰腺炎的管理方法,重点关注严重死形式.
- 突出干预措施在管理受感染的周胰腺液收集 (PFCs) 中的作用.
- 强调在严重病例中多学科方法的重要性.
主要方法:
- 保守的管理:液体复苏,营养支持,感染PFC的抗生素.
- 侵入性干预:内超声波 (EUS) 引导的排水,持续症状或感染PFCs的皮肤间排水.
- 在耐火病例中直接进行内镜式体切除术.
主要成果:
- 双模排水 (内镜和穿皮) 显示出更好的结果和更少的并发症.
- 当保守的管理失败或出现并发症时,侵入性程序至关重要.
- 一个协调的,多学科的团队方法对于成功的患者结果至关重要.
结论:
- 严重急性胰腺炎的有效管理需要一个分层的方法,从保守的措施开始,并根据需要进行侵入性干预.
- 结合内镜和皮肤通道排水策略在管理感染PFC方面提供了显著的好处.
- 对于严重瘤性胰腺炎的最佳护理需要各种医疗专家之间的合作.
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