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急性胰腺炎管理的进展

Advances in managing acute pancreatitis.

作者信息

Dimagno Matthew J, Wamsteker Erik-Jan, Debenedet Anthony T

出版信息

F1000 Med Rep. 2009;1:59. doi: 10.3410/M1-59. Epub 2009 Jul 27.

Abstract

This review highlights advances in acute pancreatitis (AP) made in the past year. We focus on clinical aspects of AP - severe disease especially - and risk stratification tools to guide the clinical care of patients. Most patients with AP have mild disease that requires a diagnostic evaluation, self-limited supportive care, and a short hospital stay. In patients with potentially severe AP, it is important for clinicians to use available risk-stratifying tools to identify high-risk patients and initiate timely interventions such as aggressive fluid resuscitation, close monitoring, early initiation of enteral nutrition, and appropriate use of endoscopic retrograde cholangio-pancreatography. This approach decreases morbidity and possibly mortality and is supported by evidence drawn from recent clinical guidelines, historical literature, and the highest quality studies published in the last year.

摘要

本综述重点介绍了过去一年中急性胰腺炎(AP)领域取得的进展。我们聚焦于AP的临床方面,尤其是重症疾病,以及用于指导患者临床护理的风险分层工具。大多数AP患者病情较轻,需要进行诊断评估、自限性支持治疗,并短期住院。对于潜在重症AP患者,临床医生使用现有的风险分层工具识别高危患者并及时启动干预措施,如积极的液体复苏、密切监测、早期肠内营养的启动以及内镜逆行胰胆管造影术的合理使用,这一点很重要。这种方法可降低发病率并可能降低死亡率,且得到了近期临床指南、历史文献以及去年发表的最高质量研究中的证据支持。

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本文引用的文献

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Meta-analysis: Nitroglycerin for prevention of post-ERCP pancreatitis.荟萃分析:硝酸甘油预防内镜逆行胰胆管造影术后胰腺炎
Aliment Pharmacol Ther. 2009 May 15;29(10):1078-85. doi: 10.1111/j.1365-2036.2009.03978.x. Epub 2009 Feb 19.
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Systematic review: nutritional support in acute pancreatitis.系统评价:急性胰腺炎的营养支持
Aliment Pharmacol Ther. 2008 Sep 15;28(6):704-12. doi: 10.1111/j.1365-2036.2008.03786.x.

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