De Waele J, Vogelaers D, Decruyenaere J, De Vos M, Colardyn F
Universitair Ziekenhuis Gent, Gent, België.
Acta Clin Belg. 2004 Mar-Apr;59(2):90-6. doi: 10.1179/acb.2004.013.
Disease severity in patients with acute pancreatitis varies from mild disease with minimal morbidity, to severe disease in which a whole spectrum of local and systemic complications may occur. Infectious complications frequently arise, and especially infection of pancreatic necrosis is an important risk factor for mortality. Several strategies have been devised to reduce this risk, and the use of prophylactic therapy, e.g. selective digestive decontamination, can be considered in patients with documented necrosis fo the pancreas. Pancreatic abscesses and infected pseudocysts arise later in the course of disease, and should be considered as separate entities, due to differences in therapy and outcome of these patients. When infection occurs, source control using either surgical or percutaneous drainage techniques, is essential to avoid systemic complications.
急性胰腺炎患者的疾病严重程度各不相同,从发病率极低的轻症到可能出现一系列局部和全身并发症的重症。感染性并发症经常出现,尤其是胰腺坏死感染是导致死亡的重要危险因素。已经制定了多种策略来降低这种风险,对于有胰腺坏死记录的患者,可以考虑使用预防性治疗,例如选择性消化道去污。胰腺脓肿和感染性假性囊肿在疾病后期出现,由于这些患者的治疗方法和预后不同,应将其视为不同的实体。当发生感染时,采用手术或经皮引流技术进行源头控制对于避免全身并发症至关重要。